Luetzow, Deborah A

Luetzow, Deborah A is an sole proprietor health care provider with primary practice located at 2413 W Rawson Ave , Oak Creek WI 53154-1323. She recently has only one registered license in Allopathic & Osteopathic Physicians / Adult Medicine, which is considered as her primary health care specialty. Luetzow, Deborah A can be contacted via phone (414) 333-0064.

Contact Information

Primary practice address
2413 W Rawson Ave Oak Creek WI 53154-1323
Phone: (414) 333-0064
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adult Medicine 207QA0505X 29691 Wisconsin

Profile Details

NPI number 1285688713
LBN Legal business name Luetzow, Deborah A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 20th, 2006
Last updated Dec 17th, 2013 - about 11 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 1285688713 NPPES
Wisconsin Other 391703395015 BLUE CROSS BLUE SHIELD
Wisconsin MEDICAID 31555700 BLUE CROSS BLUE SHIELD

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