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Individual

LEONARD E EGEDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
9200 W WISCONSIN AVE, DEPARTMENT OF INTERNAL MEDICINE, MILWAUKEE, WI 53226-3522
(414) 805-6850
(414) 805-6851
Mailing address
9200 W WISCONSIN AVE, DEPARTMENT OF INTERNAL MEDICINE, MILWAUKEE, WI 53226-3522
(414) 805-6850
(414) 805-6851

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
21049
SC
207R00000X
Internal Medicine Physician
Primary
66566
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1740398601
WI
05
T52984
SC
Enumeration date
08/29/2006
Last updated
01/05/2017
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