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Individual

MITCHELL LOUIS JUDGE LI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
420 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-4600
(920) 926-4869
Mailing address
420 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-4600
(920) 926-4869

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036143472
IL
207P00000X
Emergency Medicine Physician
4301106252
MI
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
65823-20
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4301106252
MI LIMITED LICENSE NUMBER
MI
Enumeration date
04/03/2013
Last updated
03/17/2026
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