Individual
JUSTIN J DWORAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APNP, CRNA
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-5951
(414) 805-4870
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-5951
(414) 805-4870
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
8858
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689010431
—
WI
Enumeration date
05/21/2013
Last updated
07/18/2024
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