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Individual

MR. ANTONIO ROMO DE VIVAR CHAVEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001
(800) 223-2273
Mailing address
600 HIGHLAND AVE, MADISON, WI 53792-0001
(608) 262-1986

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
6457-851
WI
208600000X
Surgery Physician
5404382
ZZ

Other

Enumeration date
03/15/2010
Last updated
12/26/2016
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