Individual
MIRLEY BUJAN CARRENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2400 W VILLARD AVE, MILWAUKEE, WI 53209-4901
(414) 527-8415
Mailing address
5905 N LYDELL AVE UNIT 502, MILWAUKEE, WI 53217-4598
(760) 996-8548
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
100787-851
WI
Other
Enumeration date
06/12/2024
Last updated
06/12/2024
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