Individual
NICHOLAS J ANTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9000 W WISCONSIN AVE, PEDIATRIC PULMONARY MEDICINE, MILWAUKEE, WI 53226-4874
(414) 266-6730
(414) 266-6742
Mailing address
9000 W WISCONSIN AVE, PEDIATRIC PULMONARY MEDICINE, MILWAUKEE, WI 53226-4874
(414) 266-6730
(414) 266-6742
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
54265
WI
2080P0214X
Pediatric Pulmonology Physician
Primary
54265
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1568787794
—
WI
Enumeration date
03/31/2010
Last updated
08/14/2013
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