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Individual

JAMES WILLIAM LEPAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
975
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
42969800
WI
01
975
STATE LICENSE
WI
Enumeration date
07/11/2006
Last updated
03/07/2023
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