Individual
THERESA MARIE PARDOE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9305 W NATIONAL AVE, WEST ALLIS, WI 53227-1541
(414) 545-1120
(414) 545-2505
Mailing address
9305 W NATIONAL AVE, WEST ALLIS, WI 53227-1541
(414) 545-1120
(414) 545-2505
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
29660
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31462700
—
WI
Enumeration date
05/20/2006
Last updated
10/01/2007
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