Organization
GREAT LAKES RADIATION ONCOLOGY,
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID M SHERMAN MD (PRESIDENT)
(414) 447-2221
Entity
Organization
Contact information
Practice address
19333 W NORTH AVE, BROOKFIELD, WI 53045-4132
(414) 447-2221
(262) 641-6880
Mailing address
19333 W NORTH AVE, BROOKFIELD, WI 53045-4132
(414) 447-2221
(262) 641-6880
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21281300
—
WI
Enumeration date
05/16/2006
Last updated
08/22/2020
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