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Individual

DR. WILLIAM J. LISTWAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
555 S 108TH ST, QUAD-MED, WEST ALLIS, WI 53214-1100
(414) 566-8210
Mailing address
N19W26595 HONEYSUCKLE CT, UNIT A, PEWAUKEE, WI 53072-5414
(414) 750-4133

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
16862
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
31206600
WI
Enumeration date
06/06/2006
Last updated
01/04/2011
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