Individual
JEREMY MICHAEL PHILIPSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2835 N GRANDVIEW BLVD STE 300, PEWAUKEE, WI 53072-5591
(262) 542-3779
(262) 542-4428
Mailing address
2835 N GRANDVIEW BLVD STE 300, PEWAUKEE, WI 53072-5591
(262) 542-3779
(262) 542-4428
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PENDING
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100177596
—
WI
Enumeration date
06/14/2018
Last updated
01/20/2025
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