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Individual

LUCIAN A DURHAM III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D., PHD

Contact information

Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 955-6900
(414) 955-6204
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 955-6900
(414) 955-6204

Taxonomy

Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
46509
MN
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
68603
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
011669600
MN
Enumeration date
01/09/2006
Last updated
01/16/2018
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