Individual
MARK A HLAVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
36500 AURORA DR, SUMMIT, WI 53066-4899
(262) 434-1900
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
33391
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001
BCBS
WI
05
—
32033700
—
WI
Enumeration date
05/10/2006
Last updated
10/02/2023
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