Healthcare Provider Details

I. General information

NPI: 1619944840
Provider Name (Legal Business Name): KURT OESTERLING MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2006
Last Update Date: 06/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 N MAYFAIR RD
WAUWATOSA WI
53226-3436
US

IV. Provider business mailing address

3003 W GOOD HOPE RD
MILWAUKEE WI
53209-2042
US

V. Phone/Fax

Practice location:
  • Phone: 414-479-8695
  • Fax: 414-476-8440
Mailing address:
  • Phone: 414-352-3100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number21799
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number21799
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: