Healthcare Provider Details

I. General information

NPI: 1114048204
Provider Name (Legal Business Name): DR. RONALD J WROBLEWSKI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 02/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7635 W OKLAHOMA AVE STE 109
MILWAUKEE WI
53219-3623
US

IV. Provider business mailing address

7635 W OKLAHOMA AVE STE 109
MILWAUKEE WI
53219-3623
US

V. Phone/Fax

Practice location:
  • Phone: 414-543-8008
  • Fax:
Mailing address:
  • Phone: 414-543-8008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number586-025
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number586-025
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: