Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 39248 | WI |
NPI | 1053310474 |
---|---|
Provider Name | Dr. David James Siverhus |
First Address | Milwaukee, WI 53226-1409 |
Second Address | Milwaukee, WI 53226-1409 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2005 |
Last Update Date | 24/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
32371900 | (05) | WI |
G59883 | (02) |