Stout, Michael David

Stout, Michael David is an individual health care provider with primary practice located at 9200 W Wisconsin Ave , Milwaukee WI 53226-3522. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Anesthesiologist Assistant, which is considered as his primary health care specialty. Stout, Michael David can be contacted via phone (414) 805-8700.

Contact Information

Primary practice address
9200 W Wisconsin Ave Milwaukee WI 53226-3522
Phone: (414) 805-8700
Fax: (414) 259-1522
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Anesthesiologist Assistant 367H00000X 74017 Wisconsin

Profile Details

NPI number 1255403812
LBN Legal business name Stout, Michael David
Credentials Associate of Arts (AA)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 15th, 2006
Last updated Jul 13th, 2023 - about last year

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 1255403812 NPPES
Wisconsin MEDICAID 1255403812

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