Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YP0228X | Pediatric Otolaryngology | 43113-020 | WI |
NPI | 1407816119 |
---|---|
Provider Name | Dr. Thomas Charles Robey |
First Address | Milwaukee, WI 53226-3518 |
Second Address | Milwaukee, WI 53226-3518 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2006 |
Last Update Date | 24/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1407816119 | (05) | WI |
30581400 | (05) | WI |
B51543 | (02) | WI |