Healthcare Provider Details

I. General information

NPI: 1730532540
Provider Name (Legal Business Name): EMILY DIXON BARASH PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2016
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 W WISCONSIN AVE DIVISION OF HEMATOLOGY AND ONCOLOGY
MILWAUKEE WI
53226-3522
US

IV. Provider business mailing address

8331 N LINKS WAY
FOX POINT WI
53217-2821
US

V. Phone/Fax

Practice location:
  • Phone: 414-805-4600
  • Fax: 414-805-2934
Mailing address:
  • Phone: 414-573-7634
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number3821 - 23
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: