Individual
REID A SOUSEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3329 N RICHMOND ST, APPLETON, WI 54911-1063
(920) 380-2720
Mailing address
3329 N RICHMOND ST, APPLETON, WI 54911-1063
(920) 380-2720
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
48401
WI
207Q00000X
Family Medicine Physician
Primary
48401
WI
2083X0100X
Occupational Medicine Physician
48401
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34818800
—
WI
Enumeration date
03/09/2006
Last updated
08/15/2024
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