Healthcare Provider Details

I. General information

NPI: 1669591640
Provider Name (Legal Business Name): WIESLAW IZYDOR FRANKOWSKI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 10/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 S 16TH ST SUITE 1000
MILWAUKEE WI
53215-4537
US

IV. Provider business mailing address

3201 S 16TH ST SUITE 1000
MILWAUKEE WI
53215-4537
US

V. Phone/Fax

Practice location:
  • Phone: 414-389-3180
  • Fax: 414-645-8240
Mailing address:
  • Phone: 414-389-3180
  • Fax: 414-645-8240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number29134
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: