Individual
LISA HAHN SPEIDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6900 N PORT WASHINGTON RD, GLENDALE, WI 53217-3921
(414) 270-8100
(414) 270-8120
Mailing address
4425 N PORT WASHINGTON RD, ATTN: CSMCP CLINIC CREDENTIALING, GLENDALE, WI 53212-1082
(414) 270-8100
(414) 270-8120
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
53897
WI
Other
Enumeration date
05/01/2008
Last updated
06/11/2012
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