Individual
MARY J KAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3400 UNION AVE, SHEBOYGAN, WI 53081-8426
(920) 828-2400
(920) 828-2425
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
68058
WI
207VG0400X
Gynecology Physician
6451-851
WI
207VX0000X
Obstetrics Physician
6451-851
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100057482
—
WI
Enumeration date
04/13/2016
Last updated
08/21/2023
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