Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 36195 | WI |
NPI | 1073620308 |
---|---|
Provider Name | Dr. Douglas E Rapisarda |
First Address | Milwaukee, WI 53215-2843 |
Second Address | Two Rivers, WI 54241 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
32090400 | (05) | WI |
BR3824263 | DEA NUMBER (01) | |
F94932 | (02) |