Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 49077 | WI |
N | 207RC0000X | Internist - Cardiovascular Disease | 49077 | WI |
Y | 207RI0011X | Interventional Cardiology | 49077-020 | WI |
NPI | 1144282120 |
---|---|
Provider Name | Dr. Peter J Mason |
First Address | Milwaukee, WI 53226-3522 |
Second Address | Milwaukee, WI 53226-3522 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2006 |
Last Update Date | 27/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1144282120 | (05) | WI |
34838100 | (05) | WI |
H31460 | (02) | WI |