Individual
MICHAEL MARQUART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2323 N LAKE DR, MILWAUKEE, WI 53211-4508
(414) 291-1149
Mailing address
4025 N 92ND ST, WAUWATOSA, WI 53222-1613
(414) 358-5437
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
42691
WI
2085R0202X
Diagnostic Radiology Physician
Primary
42691
WI
2085R0204X
Vascular & Interventional Radiology Physician
42691
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34637300
—
WI
Enumeration date
11/29/2005
Last updated
12/02/2021
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