Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 1020-25 | WI |
N | 222Z00000X | Podiatrist | 1020-25 | WI |
Y | 213ES0131X | Foot Surgery | 1020-25 | WI |
NPI | 1174843593 |
---|---|
Provider Name | Brant Mccartan |
First Address | Milwaukee, WI 53226-3255 |
Second Address | Milwaukee, WI 53226-3255 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2010 |
Last Update Date | 26/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1174843593 | (05) | WI |