Individual
DR. AMANDA CLARK WIDING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9000 W WISCONSIN AVE, MILWAUKEE, WI 53226-4874
(414) 266-3560
(414) 266-6092
Mailing address
9000 W WISCONSIN AVE, MILWAUKEE, WI 53226-4874
(414) 266-3560
(414) 266-6092
Taxonomy
Speciality
Code
Description
License number
State
207LP3000X
Pediatric Anesthesiology Physician
Primary
73238
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942682331
—
WI
Enumeration date
06/23/2015
Last updated
03/14/2024
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