Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 665 | WI |
Y | 222Z00000X | Podiatrist | 665 | WI |
N | 213ES0131X | Foot Surgery | 665 | WI |
NPI | 1013014166 |
---|---|
Provider Name | Christopher J Milkie |
First Address | Wauwatosa, WI 53226 |
Second Address | Wauwatosa, WI 53226 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 22/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
43215200 | (05) | WI |
U22676 | (02) |