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Individual

DR. EDWARD JAMES MUELLERLEILE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4267 W FOND DU LAC AVE, MILWAUKEE, WI 53216-3527
(414) 873-3440
(414) 873-3420
Mailing address
4267 W FOND DU LAC AVE, MILWAUKEE, WI 53216-3527
(414) 873-3440
(414) 873-3420

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
36573
WI
2080A0000X
Pediatric Adolescent Medicine Physician
36573
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
32466900
WI
Enumeration date
02/09/2007
Last updated
11/17/2020
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