Healthcare Provider Details

I. General information

NPI: 1376597419
Provider Name (Legal Business Name): ANTHONY HOANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 06/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21700 INTERTECH DR SPRINGDALE HEALTH CENTER
BROOKFIELD WI
53045-5197
US

IV. Provider business mailing address

21700 INTERTECH DR SPRINGDALE HEALTH CENTER
BROOKFIELD WI
53045-5197
US

V. Phone/Fax

Practice location:
  • Phone: 262-532-8300
  • Fax: 262-532-8600
Mailing address:
  • Phone: 262-532-8300
  • Fax: 262-532-8600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number0037901
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: