Healthcare Provider Details

I. General information

NPI: 1518918564
Provider Name (Legal Business Name): WILLIAM W DZWIERZYNSKI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 11/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1155 N MAYFAIR RD PLASTIC SURGERY CENTER
MILWAUKEE WI
53226-3462
US

IV. Provider business mailing address

1155 N MAYFAIR RD PLASTIC SURGERY CENTER
MILWAUKEE WI
53226-3462
US

V. Phone/Fax

Practice location:
  • Phone: 414-955-1000
  • Fax: 414-955-0183
Mailing address:
  • Phone: 414-955-1000
  • Fax: 414-955-0183

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number32182
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: