Individual
LINDA AILEEN WAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 W SILVER SPRING DR STE K340, GLENDALE, WI 53217-5065
(414) 961-9601
Mailing address
500 W SILVER SPRING DR STE K340, GLENDALE, WI 53217-5065
Taxonomy
Speciality
Code
Description
License number
State
207ZB0001X
Blood Banking & Transfusion Medicine Physician
Primary
46932-20
WI
207ZC0006X
Clinical Pathology Physician
46932-20
WI
Other
Enumeration date
10/30/2019
Last updated
10/30/2019
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