Healthcare Provider Details

I. General information

NPI: 1063590255
Provider Name (Legal Business Name): KEVIN JAMES DAHLMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3195 HILLSIDE DR
DELAFIELD WI
53018-2189
US

IV. Provider business mailing address

999 N 92ND ST
WAUWATOSA WI
53226-4875
US

V. Phone/Fax

Practice location:
  • Phone: 262-646-9960
  • Fax: 262-646-9961
Mailing address:
  • Phone: 414-266-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number49905
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: