Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 49268021 | WI |
N | 207VX0000X | Obstetrician | 5101014348 | MI |
NPI | 1457339616 |
---|---|
Provider Name | Jeremy M. Bell |
First Address | Milwaukee, WI 53215-2843 |
Second Address | Fond Du Lac, WI 54937-2999 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/01/2006 |
Last Update Date | 22/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
43531400 | (05) | WI |
H89372 | (02) | MI |