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Individual

DR. CHARLES F KIDD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2801 W. KINNICKINNIC RIVER PARKWAY, SUITE 370, MILWAUKEE, WI 53215
(414) 672-6006
(414) 672-6016
Mailing address
2801 W. KINNICKINNIC RIVER PARKWAY, SUITE 370, MILWAUKEE, WI 53215
(414) 672-6006
(414) 672-6016

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
46512020
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
340020435
MEDICARE RAILROAD
WI
05
34472100
WI
Enumeration date
03/09/2006
Last updated
05/02/2012
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