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General NPI Number Information
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NPI Number | 1245369933
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Entity Type | Individual
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Provider Name | JEFFERSON NARCISO CALIMLIM M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3267 S 16TH ST SUITE 101
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City | MILWAUKEE
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State | WI
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Zip | 53215-4500
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Country | US
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Telephone | 414-384-3838
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Fax |
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Provider Business Mailing Address
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Address Line | 3267 S 16TH ST SUITE 101
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City | MILWAUKEE
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State | WI
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Zip | 53215-4500
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Country | US
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Telephone | 414-384-3838
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 22310
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License Number State | WI
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