Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 63235 | WI |
N | 111NI0900X | Internist | 63235 | WI |
Y | 207RH0002X | Hospice and Palliative Medicine | 63235 | WI |
NPI | 1285976860 |
---|---|
Provider Name | Alexandria Bear |
First Address | Milwaukee, WI 53226-3522 |
Second Address | Milwaukee, WI 53226-3522 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2013 |
Last Update Date | 01/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1285976860 | (05) | WI |