Individual
MRS. MARA PHEISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3070 N 51ST ST STE 206, MILWAUKEE, WI 53210-1661
(414) 585-7020
(414) 585-7021
Mailing address
3070 N 51ST ST STE 206, MILWAUKEE, WI 53210-1661
(414) 585-7020
(414) 585-7021
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
52693
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1639208440
—
WI
Enumeration date
03/05/2007
Last updated
01/09/2023
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