Individual
NICHOLAS J STACHOWIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 955-6450
(414) 955-0082
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 955-6450
(414) 955-0082
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5538
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245855600
—
WI
Enumeration date
06/11/2020
Last updated
10/26/2022
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