Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 70803 | WI |
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 35.129039 | OH |
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 70803 | WI |
NPI | 1750644415 |
---|---|
Provider Name | Emily Rose Wenrich Davidson |
First Address | Milwaukee, WI 53226-3522 |
Second Address | Milwaukee, WI 53226-3522 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2012 |
Last Update Date | 11/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1750644415 | (05) | WI |