Individual
JANE A. HAWES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10950 W CAPITOL DR, WAUWATOSA, WI 53222-1110
(414) 464-4460
Mailing address
4425 N PORT WASHINGTON RD, ATTN: CSMCP CLINIC CREDENTIALING, GLENDALE, WI 53212-1082
(414) 464-4460
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
21711
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30349000
—
WI
Enumeration date
06/09/2006
Last updated
06/13/2012
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