Individual
DOUGLAS E PUFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13111 N PORT WASHINGTON RD, MEQUON, WI 53097-2416
(262) 243-7454
(262) 243-7482
Mailing address
4425 N PORT WASHINGTON ROAD, CSMCP CLINIC CREDENTIALING, GLENDALE, WI 53212-1082
(414) 326-2378
(414) 326-2155
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
40365-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34425400
—
WI
01
—
PUFFEDOU
MERCYCARE INSURANCE
WI
Enumeration date
07/23/2006
Last updated
10/22/2012
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