Individual
LAURIE B AMUNDSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4025 N 92ND ST, WAUWATOSA, WI 53222-1613
(414) 358-5431
Mailing address
4025 N 92ND ST, WAUWATOSA, WI 53222-1613
(414) 358-5431
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
39536
WI
207L00000X
Anesthesiology Physician
MD00039431
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689890816
—
WI
05
—
8277121
—
WA
Enumeration date
04/17/2007
Last updated
04/14/2022
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