Individual
EDWARD S KAPUSTKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
426 MCMILLEN ST, FORT ATKINSON, WI 53538-1996
(920) 563-7744
(920) 563-7741
Mailing address
426 MCMILLEN ST, FORT ATKINSON, WI 53538-1996
(920) 563-7744
(920) 563-7741
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
18609-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31010400
—
WI
Enumeration date
07/22/2006
Last updated
07/08/2007
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