Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 036113654 | IL |
N | 207P00000X | Emergency Physician | 51947-20 | WI |
Y | 207PE0004X | Emergency Medical Services | 227795 | MA |
NPI | 1205883766 |
---|---|
Provider Name | Peter A Henry |
First Address | Milwaukee, WI 53202-4815 |
Second Address | Milwaukee, WI 53202-4815 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2006 |
Last Update Date | 07/10/2008 |