Individual
LAURENCE DONAHUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8901 W LINCOLN AVE, WEST ALLIS, WI 53227-2409
(414) 328-6000
Mailing address
W231N1440 CORPORATE CT STE 210, WAUKESHA, WI 53186-1303
(262) 896-6000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125057552
IL
2085R0202X
Diagnostic Radiology Physician
65569
WI
2085R0204X
Vascular & Interventional Radiology Physician
Primary
65569
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100057932
—
WI
Enumeration date
07/21/2010
Last updated
08/09/2023
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