Individual
SAMANTHA J EMANUELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-4600
(414) 808-2934
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-4600
(414) 808-2934
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
3689-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1568836369
—
WI
Enumeration date
11/17/2015
Last updated
09/24/2020
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