Larson, David L

Larson, David L is an individual health care provider with primary practice located at 8700 Watertown Plank Road Wisconsin Athletic Club Bldg, Milwaukee WI 53226. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery, which is considered as his primary health care specialty. Larson, David L can be contacted via phone (414) 805-3666.

Contact Information

Primary practice address
8700 Watertown Plank Road Wisconsin Athletic Club Bldg Milwaukee WI 53226
Phone: (414) 805-3666
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery 2086S0122X 27404 Wisconsin

Profile Details

NPI number 1003867508
LBN Legal business name Larson, David L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 12th, 2006
Last updated Jul 8th, 2007 - about 17 years 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 1003867508 NPPES
Wisconsin MEDICAID 30711500

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