Individual
DR. DANIEL DIACZOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2900 W OKLAHOMA AVE, MILWAUKEE, WI 53215-4330
(414) 649-6000
Mailing address
4012 W LE MONT BLVD, MEQUON, WI 53092-5227
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
73226
WI
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
73226-21
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100101578
—
WI
Enumeration date
04/05/2015
Last updated
11/30/2021
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