Individual
DANIEL A HAGERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
N143W6515 PIONEER RD, CEDARBURG, WI 53012-2705
(262) 377-6399
Mailing address
4425 N PORT WASHINGTON RD, ATTN: CSMCP CLINIC CREDENTIALING, GLENDALE, WI 53212-1082
(262) 377-6399
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
31551
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31809800
—
WI
Enumeration date
07/17/2006
Last updated
06/11/2012
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