MEDICARE: TRANG LE DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	67808-21	WI

General Provider Information

NPI Number	:	1447660188
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRANG LE DO

Provider Business Mailing Address
First Line	:	W126N7338 FLINT DR
Second Line	:
City	:	MENOMONEE FALLS
State	:	WI
Zip	:	53051-4532
Country	:	US
Telephone Number	:	414-423-0555
Fax Number	:

Provider Business Practice Location Address
First Line	:	6220 W LOOMIS RD
Second Line	:
City	:	GREENDALE
State	:	WI
Zip	:	53129-2448
Country	:	US
Telephone Number	:	414-423-0555
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/02/2014
Last Update Date	:	10/27/2017

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Directions to “ TRANG LE DO” Practice Location

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