Individual
MICHAEL DAVID STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AA
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-8700
(414) 259-1522
Mailing address
N84W33109 BECKER LN, OCONOMOWOC, WI 53066-9733
(561) 370-5465
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
AA900
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255403812
—
WI
Enumeration date
11/15/2006
Last updated
03/12/2025
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