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General NPI Number Information
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NPI Number | 1265659676
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Entity Type | Organization
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Legal Business Name | RIVERSIDE GYNECOLOGY AND WOMEN'S HEALTHCARE
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 09/19/2007
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Provider Practice Location Address
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Address Line | 22099 DAVIDSON RD 203
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City | WAUKESHA
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State | WI
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Zip | 53186-4069
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Country | US
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Telephone | 262-446-6844
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Fax | 630-665-3868
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Provider Business Mailing Address
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Address Line | 22099 DAVIDSON RD 203
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City | WAUKESHA
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State | WI
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Zip | 53186-4069
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Country | US
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Telephone | 262-446-6844
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Fax | 630-665-3868
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ELIZABETH ANN BARON-KUHN
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Credential | MD
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Telephone | 262-446-6844
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Obstetrics & Gynecology) Physician
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License Number | 46778
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License Number State | WI
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