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Individual

ANDY KIEU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O

Contact information

Practice address
2801 W KINNICKINNIC RIVER PKWY, MILWAUKEE, WI 53215-3669
(414) 649-3390
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
64854
WI
207RC0000X
Cardiovascular Disease Physician
64854
WI
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
64854
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100049511
WI
Enumeration date
04/01/2014
Last updated
03/01/2024
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