Individual
MRS. DEBORAH COSTAKOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9000 W WISCONSIN AVE, PEDIATRIC OPHTHALMOLOGY, MILWAUKEE, WI 53226-4874
(414) 607-5280
(414) 266-2027
Mailing address
9000 W WISCONSIN AVE, PEDIATRIC OPHTHALMOLOGY, MILWAUKEE, WI 53226-4874
(414) 607-5280
(414) 266-2027
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
41333-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1568466928
—
WI
Enumeration date
06/13/2005
Last updated
03/11/2024
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