Individual
RUTH M POVLICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9000 W WISCONSIN AVE, MILWAUKEE, WI 53226-4874
(414) 266-6550
(414) 266-6579
Mailing address
9000 W WISCONSIN AVE, MILWAUKEE, WI 53226-4874
(414) 266-6550
(414) 266-6579
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4772-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760030761
—
WI
Enumeration date
09/03/2019
Last updated
06/15/2022
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