Individual
DR. KEVIN SCOTT PACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5150 N PORT WASHINGTON RD, SUITE 151, MILWAUKEE, WI 53217-5474
(414) 332-1000
(414) 332-1005
Mailing address
5150 N PORT WASHINGTON RD, SUITE 151, MILWAUKEE, WI 53217-5474
(414) 332-1000
(414) 332-1005
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
33416
WI
2086S0129X
Vascular Surgery Physician
33416
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32705400
—
WI
Enumeration date
07/21/2005
Last updated
03/18/2008
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