Individual
MR. EMMANUEL ESIANOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
2800 WESTHILL DR, STE 200, WAUSAU, WI 54401-3771
(715) 843-1000
(715) 843-1001
Mailing address
2800 WESTHILL DR, STE 200, WAUSAU, WI 54401-3771
(715) 843-1000
(715) 843-1001
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3086-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3086-23
LICENSE
WI
Enumeration date
10/14/2011
Last updated
03/06/2013
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