Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 63081 | WI |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 63081 | WI |
N | 208200000X | Surgeon | 112649 | CA |
N | 208600000X | Surgeon | 112649 | CA |
NPI | 1831359801 |
---|---|
Provider Name | Dr. Ethan B. Handler |
First Address | Wauwatosa, WI 53226-4851 |
Second Address | Milwaukee, WI 53222-4404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2008 |
Last Update Date | 05/01/2022 |