Individual
LEE S WANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
601 N 99TH ST, STE 201, WAUWATOSA, WI 53226-4339
(414) 778-7790
(414) 778-7646
Mailing address
601 N 99 ST, STE 201, WAUWATOSA, WI 53226
(414) 778-7790
(414) 778-7646
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
22145
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30263800
—
WI
Enumeration date
03/27/2006
Last updated
03/25/2013
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