Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 2020041696 | MO |
Y | 208600000X | Surgeon | 2020041696 | MO |
N | 2082S0105X | Plastic Hand Surgeon | 2020041696 | MO |
NPI | 1437546264 |
---|---|
Provider Name | Chase Tobin |
First Address | Milwaukee, WI 53226-3595 |
Second Address | Milwaukee, WI 53226-3595 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2015 |
Last Update Date | 08/03/2021 |