Individual
JEAN MARIE RIQUELME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 N NINE MOUND RD, VERONA, WI 53593-1032
(608) 845-9531
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
36042-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32097700
—
WI
01
—
36042
LICENSE
WI
01
—
MD60319995
LICENSE
WA
Enumeration date
12/06/2005
Last updated
05/23/2023
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