Healthcare Provider Details

I. General information

NPI: 1477780237
Provider Name (Legal Business Name): ERIN L DOREN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2009
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1155 N MAYFAIR RD PLASTIC SURGERY STE. T2600
MILWAUKEE WI
53226-3462
US

IV. Provider business mailing address

1155 N MAYFAIR RD PLASTIC SURGERY STE. T2600
MILWAUKEE WI
53226-3462
US

V. Phone/Fax

Practice location:
  • Phone: 414-955-1000
  • Fax:
Mailing address:
  • Phone: 414-955-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number65677
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number036174228
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License NumberQ2437
License Number StateTN
# 4
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number65677
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: