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Individual

MR. DAVID RADOVICH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSYD

Contact information

Practice address
2675 N MAYFAIR RD STE 400, MILWAUKEE, WI 53226-1305
(414) 763-6910
(414) 763-6911
Mailing address
2675 N MAYFAIR RD STE 400, MILWAUKEE, WI 53226-1305
(414) 763-6910
(414) 763-6911

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3445-57
WI
103TC0700X
Clinical Psychologist
3445-57
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1649588872
WI
Enumeration date
09/22/2010
Last updated
11/03/2022
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