Individual
DR. MARY BETH PHELAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-6450
(414) 805-6464
Mailing address
9200 W WISCONSIN AVE, DEPT 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
33549
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002000129X
HUMANA
—
05
—
1356393037
—
WI
Enumeration date
05/17/2006
Last updated
05/04/2018
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