Individual
DR. MARY SUSAN JAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8915 W CONNELL AVE, MILWAUKEE, WI 53226-3067
(414) 266-2873
(414) 337-7860
Mailing address
8915 W CONNELL AVE, MILWAUKEE, WI 53226-3067
(414) 266-2873
(414) 337-7860
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
47315
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000030377M
HUMANA
—
05
—
1649221482
—
WI
05
—
34582200
—
WI
Enumeration date
05/15/2006
Last updated
06/03/2019
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