Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 24889-20 | WI |
NPI | 1174572861 |
---|---|
Provider Name | Dr. Don A Bukstein |
First Address | Greenfield, WI 53228 |
Second Address | Fitchburg, WI 53711 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2006 |
Last Update Date | 10/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
118 | DEAN HEALTH INSURANCE (01) | WI |
30473100 | (05) | WI |
B51844 | (02) | |
B51844 | (02) | WI |