Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | 65593 | WI |
N | 2080P0201X | Pediatric Allergist | 036133499 | IL |
Y | 2080P0201X | Pediatric Allergist | 65593 | WI |
NPI | 1700103272 |
---|---|
Provider Name | Dr. Barry Joel Pelz |
First Address | Milwaukee, WI 53226-4874 |
Second Address | Milwaukee, WI 53226-4874 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2010 |
Last Update Date | 15/07/2016 |