Individual
DOUGLAS J. WERMUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4600 W LOOMIS RD STE 201, GREENFIELD, WI 53220-4858
(414) 281-4466
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(414) 281-4466
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
30174-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31496300
—
WI
Enumeration date
08/18/2005
Last updated
10/10/2023
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