Individual
DR. STEPHEN K SPONAGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1155 NORTH MAYFAIR ROAD, BEHAVIORAL HEALTH CLINIC @ TOSA, MILWAUKEE, WI 53226
(414) 805-3666
Mailing address
1155 N MAYFAIR RD, BEHAVIORAL HEALTH CLINIC @ TOSA, MILWAUKEE, WI 53226-3421
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
47580
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34601100
—
WI
Enumeration date
05/15/2006
Last updated
07/08/2007
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