Individual
ELIZABETH DZWONCZYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1475 W GRAND AVE, PORT WASHINGTON, WI 53074-2074
(262) 268-5100
Mailing address
1475 W GRAND AVE, PORT WASHINGTON, WI 53074-2074
(262) 268-5100
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
68158-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100072808
—
WI
Enumeration date
04/02/2016
Last updated
05/19/2023
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