Individual
SUSAN M KSIAZEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2727 PLAZA DR, WAUSAU, WI 54401-4192
(715) 841-4950
Mailing address
1000 N OAK AVE, MARSHFIELD, WI 54449-5703
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
036104545
IL
207W00000X
Ophthalmology Physician
Primary
70365
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036104545
—
IL
Enumeration date
12/29/2006
Last updated
06/19/2025
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