Individual
MARIO GARRETTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6308 8TH AVE, STE 202, KENOSHA, WI 53143
(262) 653-5330
(262) 653-5346
Mailing address
6308 8TH AVE, STE 202, KENOSHA, WI 53143
(262) 653-5330
(262) 653-5346
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25077
WI
207RG0100X
Gastroenterology Physician
Primary
25077
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30504200
—
WI
Enumeration date
05/26/2006
Last updated
03/13/2008
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