Individual
BRYAN J WEBSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
251 E COTTAGE GROVE RD, COTTAGE GROVE, WI 53527-9619
(608) 839-3515
Mailing address
251 E COTTAGE GROVE RD, COTTAGE GROVE, WI 53527-9619
(608) 824-4000
(608) 824-4917
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
56729-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1275845497
—
WI
Enumeration date
07/02/2010
Last updated
11/02/2020
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