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Individual

DR. BOHDAN K WASILJEW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
510 N TERRACE ST, JANESVILLE, WI 53548-2906
(608) 756-7277
Mailing address
510 N TERRACE ST, JANESVILLE, WI 53548-2906
(608) 756-7277

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
34717
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
31953600
WI
Enumeration date
01/04/2007
Last updated
07/08/2007
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