Individual
RICARDO S MASTROLIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1020 N 12TH ST, MILWAUKEE, WI 53233-1308
(414) 219-4100
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(180) 032-6225
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
25MA08075900
NJ
207V00000X
Obstetrics & Gynecology Physician
53071-20
WI
207VM0101X
Maternal & Fetal Medicine Physician
25MA08075900
NJ
207VM0101X
Maternal & Fetal Medicine Physician
Primary
53071-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588853667
—
WI
Enumeration date
10/15/2007
Last updated
06/04/2024
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