Individual
JUSTIN KO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-2715
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
84821-875
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295551232
—
WI
Enumeration date
11/25/2024
Last updated
12/05/2024
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