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Individual

GRETCHEN E DURKIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2350 N LAKE DR, SUITE 406, MILWAUKEE, WI 53211-4528
(414) 271-4141
(414) 271-4343
Mailing address
4425 N PORT WASHINGTON RD, ATTN: CSMCP CLINIC CREDENTIALING, GLENDALE, WI 53212-1082
(414) 271-4141
(414) 271-4343

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
24504
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30729700
WI
Enumeration date
04/14/2007
Last updated
06/12/2012
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