Decarlo, John Dominic

Decarlo, John Dominic is an sole proprietor health care provider with primary practice located at 16650 W Bluemound Rd # 400B , Brookfield WI 53005-5920. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Decarlo, John Dominic can be contacted via phone (414) 476-5120.

Contact Information

Primary practice address
16650 W Bluemound Rd # 400B Brookfield WI 53005-5920
Phone: (414) 476-5120
Fax: (414) 476-5181
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 21652-020 Wisconsin

Profile Details

NPI number 1346204757
LBN Legal business name Decarlo, John Dominic
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 13th, 2006
Last updated Feb 19th, 2024 - about 10 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346204757 NPPES
Wisconsin Other 391382883015 BLUE CROSS BLUE SHIELD
Wisconsin MEDICAID 30261600 BLUE CROSS BLUE SHIELD

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