Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | 1825-023 | WI |
NPI | 1134232663 |
---|---|
Provider Name | Richard K Milewicz II |
First Address | Manitowoc, WI 54221-2290 |
Second Address | Manitowoc, WI 54220-3712 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2006 |
Last Update Date | 25/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03595851 | (05) | NY |
Q33136 | (02) |