Individual
ELLIOT M SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
N91W15750 FALLS PKWY, MENOMONEE FALLS, WI 53051-2301
(262) 532-1100
(262) 532-1409
Mailing address
N91W15750 FALLS PKWY, MENOMONEE FALLS, WI 53051-2301
(262) 532-1100
(262) 532-1409
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3457-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750779856
—
WI
Enumeration date
12/26/2014
Last updated
11/03/2021
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