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Individual

SAMUEL DAVID RACETTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2801 W KINNICKINNIC RIVER PKWY, MILWAUKEE, WI 53215-3669
(414) 385-1922
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(414) 385-1922

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
125069920
IL
207Y00000X
Otolaryngology Physician
Primary
81935
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100245830
WI
Enumeration date
03/19/2017
Last updated
08/17/2023
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