Individual
BRIAN A WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AA
Contact information
Practice address
4025 N 92ND ST, WAUWATOSA, WI 53222-1613
(414) 358-5431
Mailing address
4025 N 92ND ST, WAUWATOSA, WI 53222-1613
(414) 358-5431
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
35
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100030939
—
WI
Enumeration date
06/14/2013
Last updated
07/13/2023
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