Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 24043 | WI |
Y | 207VE0102X | Reproductive Endocrinologist | 24043 | WI |
NPI | 1558312207 |
---|---|
Provider Name | Dr. Estil Strawn |
First Address | Kenosha, WI 53142-8420 |
Second Address | Kenosha, WI 53142-8420 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2006 |
Last Update Date | 24/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002000198D | HUMANA (01) | |
1558312207 | (05) | WI |
B56930 | (02) |