Individual
DR. SARAH GIDAN DEITCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9200 W WISCONSIN AVE, DEPT OF RADIOLOGY, MILWAUKEE, WI 53226-3522
(414) 805-3700
(414) 805-3777
Mailing address
9200 W WISCONSIN AVE, DEPT OF RADIOLOGY, MILWAUKEE, WI 53226-3522
(414) 805-3700
(414) 805-3777
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2008016453
MO
2085R0202X
Diagnostic Radiology Physician
125055703
IL
2085R0202X
Diagnostic Radiology Physician
Primary
63979
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235391236
—
WI
Enumeration date
06/30/2008
Last updated
06/17/2015
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