Individual
DR. ANDREW BRADFORD INGRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2600 KILEY WAY, PLYMOUTH, WI 53073-5020
(920) 449-7000
Mailing address
3301 W FOREST HOME AVE, MILWAUKEE, WI 53215-2843
(414) 389-2233
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
MD-45463
IA
207Q00000X
Family Medicine Physician
Primary
73536
WI
207Q00000X
Family Medicine Physician
R-10753
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100100690
—
WI
Enumeration date
07/06/2016
Last updated
12/06/2021
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