Individual
GLENN C CAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
201 N MAYFAIR RD, 2ND FLOOR, WAUWATOSA, WI 53226-4216
(414) 771-8228
Mailing address
201 N MAYFAIR RD, 2ND FLOOR, WAUWATOSA, WI 53226-4216
(414) 771-8228
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34605
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30067400
—
WI
Enumeration date
08/30/2006
Last updated
09/18/2008
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