Individual
RICHARD J. WAKEFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
36500 AURORA DR, SUMMIT, WI 53066-4899
(262) 434-1000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
22059
WI
207RI0011X
Interventional Cardiology Physician
Primary
22059
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30448400
—
WI
01
—
P00452820
RR MEDICARE
WI
Enumeration date
07/28/2006
Last updated
10/30/2024
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