Individual
DR. DANIEL O JOHNSRUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2900 W OKLAHOMA AVE, MILWAUKEE, WI 53215-4330
(414) 649-6000
Mailing address
PO BOX 735031, CHICAGO, IL 60673-5031
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
60783
MN
207RC0000X
Cardiovascular Disease Physician
69015
WI
207RI0011X
Interventional Cardiology Physician
Primary
69015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100058947
—
WI
Enumeration date
05/22/2015
Last updated
09/07/2023
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