Individual
DR. MICHAEL DAVID MOTHS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9200 W WISCONSIN AVE, CLINICAL CANCER CENTER BUILDING, 5TH FLOOR, STE. C5400, MILWAUKEE, WI 53226-3522
(414) 805-0812
Mailing address
9200 W WISCONSIN AVE, CLINICAL CANCER CENTER BUILDING, 5TH FLOOR, STE. C5400, MILWAUKEE, WI 53226-3522
(414) 805-0812
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
70873-20
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/29/2017
Last updated
07/29/2020
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