Individual
JONATHAN R. BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
S74 W16775 JANESVILLE RD., MUSKEGO, WI 53150-7742
(414) 422-2180
(414) 422-2185
Mailing address
100-15TH AVE., STE #180, SOUTH MILWAUKEE, WI 53172-1160
(414) 422-2120
(414) 422-2185
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
30106
WI
207X00000X
Orthopaedic Surgery Physician
4301049407
MI
Other
Enumeration date
11/03/2006
Last updated
11/22/2021
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