Individual
MILAN JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2300 WESTERN AVE, MANITOWOC, WI 54220-3712
(920) 320-3165
(930) 320-3169
Mailing address
PO BOX 2290, MANITOWOC, WI 54221-2290
(920) 320-2591
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
32315
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208600000X
—
WI
05
—
34516300
—
WI
Enumeration date
09/07/2005
Last updated
11/28/2011
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