Healthcare Provider Details

I. General information

NPI: 1447201363
Provider Name (Legal Business Name): SELIM Y FIRAT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 04/07/2023
Certification Date: 04/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 W WISCONSIN AVE RADIATION ONCOLOGY
MILWAUKEE WI
53226-3522
US

IV. Provider business mailing address

9200 W WISCONSIN AVE RADIATION ONCOLOGY
MILWAUKEE WI
53226-3522
US

V. Phone/Fax

Practice location:
  • Phone: 414-805-4400
  • Fax: 414-805-4405
Mailing address:
  • Phone: 414-805-4400
  • Fax: 414-805-4405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number40322
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: