Individual
MRS. MARY-ANNE OTTILIE KOWOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1155 N MAYFAIR RD, DEPARTMENT OF PSYCHIATRY, MILWAUKEE, WI 53226-3462
(414) 955-8990
(414) 955-6299
Mailing address
1155 N MAYFAIR RD, DEPARTMENT OF PSYCHIATRY, MILWAUKEE, WI 53226-3462
(414) 955-8990
(414) 955-6299
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
28168
OK
2084P0800X
Psychiatry Physician
Primary
50941
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200340610A
—
OK
Enumeration date
10/03/2006
Last updated
02/02/2016
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