Individual
DR. MARIO RICCARDO COLELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
9200 W WISCONSIN AVE, DEPARTMENT OF EMERGENCY MEDICINE, MILWAUKEE, WI 53226-3522
(414) 805-6450
(414) 805-6464
Mailing address
9200 W WISCONSIN AVE, DEPARTMENT OF EMERGENCY MEDICINE, MILWAUKEE, WI 53226-3522
(414) 805-6450
(414) 805-6464
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
50358
WI
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
H0060361
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336106277
—
WI
Enumeration date
04/26/2006
Last updated
03/07/2013
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