Individual
CHRISTOPHER THOMAS WICKMAN
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) 805-3750
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-3750
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
62399
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1831329267
—
WI
Enumeration date
07/20/2009
Last updated
08/30/2022
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