Individual
DR. JACOB ROBERT PESCHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-8623
(414) 805-8641
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-8623
(414) 805-8641
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
56830
WI
2086S0102X
Surgical Critical Care Physician
Primary
56830
WI
2086S0127X
Trauma Surgery Physician
56830
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396060679
—
WI
Enumeration date
03/30/2010
Last updated
06/24/2021
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