Organization
WISCONSIN BARIATRICS, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANA L PAUL (BILLING REP)
(414) 281-9665
Entity
Organization
Contact information
Practice address
4600 W LOOMIS RD, SUITE 101, MILWAUKEE, WI 53220-4858
(414) 281-9665
(414) 281-9674
Mailing address
4600 W LOOMIS RD, SUITE 101, MILWAUKEE, WI 53220-4858
(414) 281-9665
(414) 281-9674
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21259000
—
WI
Enumeration date
02/10/2006
Last updated
10/29/2007
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