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Individual

DR. JAMES PATRICK KETTERHAGEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
204 N 86TH ST, WAUWATOSA, WI 53226-4608
(561) 319-2133
(561) 634-2015
Mailing address
204 N 86TH ST, WAUWATOSA, WI 53226-4608
(561) 319-2133
(561) 634-2015

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
22425
WI
208600000X
Surgery Physician
ME 102903
FL

Other

Enumeration date
10/09/2008
Last updated
01/15/2010
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