Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 40835 | WI |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 153589 | OR |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 40835 | WI |
N | 207VX0000X | Obstetrician | 153589 | OR |
NPI | 1215989751 |
---|---|
Provider Name | Mary B. Ames |
First Address | Milwaukee, WI 53215-2843 |
Second Address | Kenosha, WI 53142-7884 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2006 |
Last Update Date | 19/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
32579900 | (05) | WI |