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Individual

DR. VALERIA D HAIRSTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPM

Contact information

Practice address
2555 N DR MARTIN LUTHER KING JR DR, MILWAUKEE, WI 53212-2709
(414) 372-8080
(414) 562-8084
Mailing address
2555 N MARTIN LUTHER KING DR, MILWAUKEE HEALTH SERVICES, INC., MILWAUKEE, WI 53212-2709
(414) 372-8080
(414) 372-0793

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
00974
MD
213E00000X
Podiatrist
Primary
957-25
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
026900106
MEDICARE PTAN
WI
05
100001611
WI
05
443048401
MD
01
RAILROAD MEDICARE
480006442
MD
01
T192VD
BLUE CROSS BLUE SHIELD
MD
Enumeration date
02/08/2006
Last updated
07/03/2024
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