Individual
DAMILOLA IDOWU-ELLSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(412) 495-5645
(414) 955-0082
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(412) 495-5645
(414) 955-0082
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
76660-20
WI
207PT0002X
Medical Toxicology (Emergency Medicine) Physician
76660-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679060933
—
WI
Enumeration date
04/21/2018
Last updated
04/15/2024
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