Individual
KATIE R HAUSMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
801 S 70TH ST, GATEWAY MEDICAL CLINIC, WEST ALLIS, WI 53214-3147
(414) 773-6600
(414) 773-6656
Mailing address
4425 N PORT WASHINGTON RD, CSMCP CLINIC CREDENTIALING, GLENDALE, WI 53212-1082
(414) 326-2218
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
61973
WI
207R00000X
Internal Medicine Physician
MD0000048457
TN
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
61973
WI
Other
Enumeration date
04/09/2009
Last updated
08/24/2015
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