Individual
DR. JESSE E BAUWENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 N MAYFAIR RD STE 500, MILWAUKEE, WI 53226-1415
(414) 257-2525
(414) 257-1772
Mailing address
2500 N MAYFAIR RD STE 500, MILWAUKEE, WI 53226-1415
(414) 257-2525
(414) 257-1772
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
50174
KY
207X00000X
Orthopaedic Surgery Physician
Primary
61173-20
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100034131
—
WI
01
—
P01922788
MEDICARE RR KY
KY
Enumeration date
04/09/2012
Last updated
10/17/2018
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