Individual
DR. TAMARA L LYDAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
700 PARK RIDGE LN, NORTH FOND DU LAC, WI 54937-1385
(920) 926-7800
(920) 496-4705
Mailing address
3301 W FOREST HOME AVE, MILWAUKEE, WI 53215-2843
(414) 389-2233
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036121487
IL
207Q00000X
Family Medicine Physician
11013444A
IN
207Q00000X
Family Medicine Physician
Primary
48503
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100004109
—
WI
Enumeration date
05/18/2007
Last updated
07/21/2022
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