Individual
DR. MICHAEL ANTHONY PUGNALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10400 75TH ST, KENOSHA, WI 53142-7884
(262) 945-5600
(262) 948-5735
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
036143414
IL
207L00000X
Anesthesiology Physician
Primary
101260
WI
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
125063129
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100255476
—
WI
Enumeration date
05/23/2013
Last updated
08/29/2024
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