Individual
MR. DANIEL WONG LOPEZ-TAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
850 ELM GROVE RD, ELM GROVE, WI 53122-2527
(262) 879-8014
Mailing address
15575 GRANDVIEW DRIVE LOWER, BROOKFIELD, WI 53005-2982
(414) 755-9104
(414) 777-1812
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35095
WI
Other
Enumeration date
05/30/2006
Last updated
11/14/2023
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