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Individual

ANTELMO ROJAS MARTINEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
5900 S LAKE DR, CUDAHY, WI 53110-3171
(414) 489-9000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(414) 489-9000

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4519
WI
363AS0400X
Surgical Physician Assistant

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100087113
WI
Enumeration date
03/25/2019
Last updated
08/29/2024
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