Individual
DR. MICHAEL J PTACIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9200 W WISCONSIN AVE, DIVISION OF CARDIOVASCULAR MEDICINE, MILWAUKEE, WI 53226-3522
(414) 805-6633
(414) 805-6280
Mailing address
9200 W WISCONSIN AVE, DIVISION OF CARDIOVASCULAR MEDICINE, MILWAUKEE, WI 53226-3522
(414) 805-6633
(414) 805-6280
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
20241
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002000130I
HUMANA
—
05
—
1407808108
—
WI
05
—
30338100
—
WI
Enumeration date
05/17/2006
Last updated
08/16/2012
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