Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 27484 | WI |
Y | 208600000X | Surgeon | 27484 | WI |
N | 2086S0129X | Vascular Surgeon | 27484 | WI |
NPI | 1073513974 |
---|---|
Provider Name | Dr. Allan Richard Pasch |
First Address | Cudahy, WI 53110-3171 |
Second Address | Cudahy, WI 53110-3171 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2005 |
Last Update Date | 29/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
32705400 | (05) | WI |
B55609 | (02) | WI |