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Individual

DR. VERONA MAIERHOFER ITTIARA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
701 GROVE AVE, WILD ROSE, WI 54984-6901
(920) 622-3257
Mailing address
701 GROVE AVE, WILD ROSE, WI 54984-6901
(920) 622-5560
(920) 622-5598

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2012033510
MO
207Q00000X
Family Medicine Physician
1905-850
WI

Other

Enumeration date
11/02/2006
Last updated
02/10/2020
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