Individual
LUIS FELIPE CARRILLO POLANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226
(414) 805-3666
(414) 805-6980
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-3666
(414) 805-6980
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
63966
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1952741621
—
WI
Enumeration date
06/26/2013
Last updated
02/03/2023
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