Individual
KATIE JO MERIDETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-6450
(414) 805-6464
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-6450
(414) 805-6464
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
4301094923
MI
207P00000X
Emergency Medicine Physician
Primary
67736
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437389954
—
WI
Enumeration date
07/17/2009
Last updated
07/21/2022
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