Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 25815 | WI |
NPI | 1518934157 |
---|---|
Provider Name | Dianne Lynn Zwicke |
First Address | Milwaukee, WI 53215-4330 |
Second Address | Milwaukee, WI 53215 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2006 |
Last Update Date | 27/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
30603400 | (05) | WI |
B57859 | (02) |