Organization
KENOSHA HAND & PLASTIC SURGERY SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL BIRNDORF MD (OWNER)
(262) 656-8237
Entity
Organization
Contact information
Practice address
10117 74TH ST STE 100, KENOSHA, WI 53142-7542
(262) 656-8237
(622) 453-0882
Mailing address
6308 8TH AVE # 104, KENOSHA, WI 53143-5031
(262) 656-8237
(262) 671-2134
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
33466020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31835100
—
WI
Enumeration date
01/10/2014
Last updated
06/10/2024
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