Individual
ZANE STAUBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8901 W LINCOLN AVE, WEST ALLIS, WI 53227-2409
(414) 328-7950
(414) 328-8505
Mailing address
8901 W LINCOLN AVE, WEST ALLIS, WI 53227-2409
(414) 328-7950
(414) 328-8505
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
TL.0005888
CO
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
73434-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
73434-20
MEDICAL LICENSE
WI
Enumeration date
12/20/2017
Last updated
08/03/2020
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