Individual
CORY RYAN DUBOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2900 W OKLAHOMA AVE, MILWAUKEE, WI 53215-4330
(414) 649-6000
Mailing address
2901 W KINNICKINNIC RIVER PKWY STE 309, MILWAUKEE, WI 53215-3660
(414) 385-4262
Taxonomy
Speciality
Code
Description
License number
State
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
Primary
67295
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100055842
—
WI
Enumeration date
02/20/2016
Last updated
12/01/2021
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