Individual
CONSTANTIN NAUTNAY JAEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2301 N LAKE DR, MILWAUKEE, WI 53211-4508
(414) 585-1000
Mailing address
3175 LILLY RD UNIT 107, BROOKFIELD, WI 53005-7602
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
74896-20
WI
Other
Enumeration date
06/18/2017
Last updated
10/08/2024
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