Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 31560 | WI |
NPI | 1154411486 |
---|---|
Provider Name | Paul Henry Hunter |
First Address | Milwaukee, WI 53202-3613 |
Second Address | Milwaukee, WI 53202-3613 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 22/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F36976 | (02) |