Individual
LAURA L RADKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
N14W23900 STONE RIDGE DR, PROHEALTH CARE MEDICAL ASSOCIATES, WAUKESHA, WI 53188-1135
(262) 574-8000
Mailing address
N14W23900 STONE RIDGE DR, PROHEALTH CARE MEDICAL ASSOCIATES, WAUKESHA, WI 53188-1135
(262) 574-8000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
31373
WI
207RI0200X
Infectious Disease Physician
Primary
31373
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31870200
—
WI
Enumeration date
10/24/2006
Last updated
01/09/2012
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