Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RI0200X | Infectious Disease | 50512-020 | WI |
NPI | 1083679518 |
---|---|
Provider Name | Maye R Berroya |
First Address | Milwaukee, WI 53215-2843 |
Second Address | Oshkosh, WI 54904-7668 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2006 |
Last Update Date | 22/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1810292000 | (05) | WV |
2437910 | (05) | OH |
34991200 | (05) | WI |
64347511 | (05) | KY |
H09423 | (02) | WV |