Healthcare Provider Details

I. General information

NPI: 1962453407
Provider Name (Legal Business Name): CHERYL A MUSZYNSKI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9000 W WISCONSIN AVE CHILDREN'S HEALTH SYS OFFICE BLDG
MILWAUKEE WI
53226
US

IV. Provider business mailing address

9000 W WISCONSIN AVE CHILDREN'S HEALTH SYS OFFICE BLDG
MILWAUKEE WI
53226-3518
US

V. Phone/Fax

Practice location:
  • Phone: 414-805-3666
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number42781
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: