Individual
DR. BERNARD J STALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2801 W KINNICKINNIC RIVER PKWY, SUITE 840, MILWAUKEE, WI 53215-3669
(414) 649-3530
(414) 649-3551
Mailing address
PO BOX 2040, MILWAUKEE, WI 53201-2040
(414) 649-3530
(414) 649-3529
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
18507-020
WI
207RC0000X
Cardiovascular Disease Physician
Primary
18507
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30239700
—
WI
Enumeration date
07/21/2005
Last updated
08/31/2009
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