Individual
DR. ALISA ANNE CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
12635 W. BLUEMOUND ROAD, BROOKFIELD, WI 53005-8004
(414) 258-0606
(414) 258-1953
Mailing address
9000 W WISCONSIN AVE, MS 958, MILWAUKEE, WI 53226-4874
(414) 266-7615
(414) 266-6238
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
51476
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912077686
—
WI
Enumeration date
11/09/2006
Last updated
06/17/2016
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