Individual
DR. CHARLENE VANDER ZANDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1155 N MAYFAIR RD, PLANK ROAD CLINIC, MILWAUKEE, WI 53226-3462
(414) 955-5990
(414) 955-6282
Mailing address
1155 N MAYFAIR RD, PLANK ROAD CLINIC, MILWAUKEE, WI 53226-3462
(414) 955-5990
(414) 955-6282
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
54553-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235339532
—
WI
Enumeration date
07/24/2007
Last updated
02/10/2014
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