Organization
PEDIATRICS WEST
Active
Other names
Lorelle M Manion MD, SC
Organization subpart
No
Provider details
NPI number
Authorized official
LORELLE M MANION MD (MD)
(262) 784-3200
Entity
Organization
Contact information
Practice address
1305 N BARKER RD, SUITE 1, BROOKFIELD, WI 53045-5230
(262) 784-3200
(262) 784-8198
Mailing address
1305 N BARKER RD, SUITE 1, BROOKFIELD, WI 53045-5230
(262) 784-3200
(262) 784-8198
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35609-020
WI
208000000X
Pediatrics Physician
45644-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32207500
—
WI
05
—
34532400
—
WI
Enumeration date
11/05/2008
Last updated
11/05/2008
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