Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0105X | Surgery of the Hand | 16789 | WI |
NPI | 1891796751 |
---|---|
Provider Name | Lewis Chamoy |
First Address | Milwaukee, WI 53226-1409 |
Second Address | Milwaukee, WI 53226-1409 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2005 |
Last Update Date | 24/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
30887300 | (05) | WI |
B52012 | (02) |