Individual
CHRISTOPHER M EERNISSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O..
Contact information
Practice address
1475 W GRAND AVE, PORT WASHINGTON, WI 53074
(262) 268-5100
Mailing address
1475 W GRAND AVE, PORT WASHINGTON, WI 53074-2074
(262) 268-5100
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
69565
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100079606
—
WI
Enumeration date
06/14/2015
Last updated
12/02/2021
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