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Individual

DENNIS WORTHINGTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
201 N MAYFAIR ROAD, WAUWATOSA, WI 53226-4216
(414) 259-7480
(414) 259-7481
Mailing address
201 N MAYFAIR ROAD, WAUWATOSA, WI 53226-4216
(414) 259-7480
(414) 259-7481

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
23370
WI
207VM0101X
Maternal & Fetal Medicine Physician
Primary
23370
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1245224864
WI
05
30340800
WI
Enumeration date
09/09/2005
Last updated
02/06/2012
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