Individual
DR. DOUGLAS M DEWIRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1111 DELAFIELD ST, SUITE 207, WAUKESHA, WI 53188-3417
(262) 446-3593
(262) 547-0379
Mailing address
1111 DELAFIELD ST, SUITE 207, WAUKESHA, WI 53188-3417
(262) 446-3593
(262) 547-0379
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
29617
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31928700
—
WI
01
—
391345728029
ANTHEM BLUE CROSS BLUE SH
WI
Enumeration date
09/25/2006
Last updated
01/15/2016
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