Individual
KATHRYN M HABERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
36500 AURORA DR, SUMMIT, WI 53066-4899
(262) 434-1000
(920) 434-5050
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
67118
WI
2086S0127X
Trauma Surgery Physician
67118
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100065608
—
WI
05
—
1841686326
—
WI
Enumeration date
04/10/2015
Last updated
09/21/2023
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