Individual
DOROTHY DELISLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
N14W23900 STONE RIDGE DR, PROHEALTH CARE MEDICAL ASSOCIATES INC., WAUKESHA, WI 53188-1135
(262) 574-8050
Mailing address
N14W23900 STONE RIDGE DR, PROHEALTH CARE MEDICAL ASSOCIATES INC., WAUKESHA, WI 53188-1135
(262) 574-8050
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
37892
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32263100
—
WI
Enumeration date
02/07/2006
Last updated
04/23/2012
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