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Individual

DR. PRIMITIVO I REYNALDO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
10200 W INNOVATION DR, SUITE 700, MILWAUKEE, WI 53226-4825
(414) 302-9196
Mailing address
225 S EXECUTIVE DR, BROOKFIELD, WI 53005-4266
(262) 787-4026

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
20320-020
WI

Other

Enumeration date
12/01/2005
Last updated
07/08/2007
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