Individual
MR. JOHN A. CHARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9200 W WISCONSIN AVE, NEOPLASTIC DISEASES FROEDTERT EAST CLINIC BLDG, MILWAUKEE, WI 53226-3522
(414) 805-4612
(414) 805-6808
Mailing address
9200 W WISCONSIN AVE, NEOPLASTIC DISEASES FROEDTERT EAST CLINIC BLDG, MILWAUKEE, WI 53226-3522
(414) 805-4612
(414) 805-6808
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
42947
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386668192
—
WI
Enumeration date
07/26/2006
Last updated
10/01/2020
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