Individual
DR. BETH A DAMITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2400 W VILLARD AVE, WFHC GLENDALE FAMILY CENTER, MILWAUKEE, WI 53209-4901
(414) 527-8191
(414) 527-8046
Mailing address
2400 W VILLARD AVE, WFHC GLENDALE FAMILY CENTER, MILWAUKEE, WI 53209-4901
(414) 527-8191
(414) 527-8046
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
39570
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000025937B
HUMANA
—
05
—
1700837879
—
WI
Enumeration date
05/13/2006
Last updated
10/08/2013
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