Individual
DR. CRAIN HENRY BLIWAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11101 W LINCOLN AVE, WEST ALLIS, WI 53227-1133
(414) 203-4500
Mailing address
11101 W LINCOLN AVE, WEST ALLIS, WI 53227-1133
(414) 203-4500
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
19951
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30119800
—
WI
Enumeration date
11/01/2006
Last updated
07/08/2007
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