Individual
KEVIN GLATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9000 W SURA LN, GREENFIELD, WI 53228-3477
(414) 246-6800
Mailing address
3301 W FOREST HOME AVE, MILWAUKEE, WI 53215-2843
(414) 389-2233
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
72751
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100101138
—
WI
Enumeration date
04/17/2016
Last updated
11/22/2021
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