Individual
DR. GUILLERMO CARRERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-3044
(414) 259-9290
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-3044
(414) 259-9290
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
20857
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002000112
HUMANA
—
05
—
1821049214
—
WI
05
—
30154800
—
WI
Enumeration date
05/12/2006
Last updated
01/14/2021
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