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General NPI Number Information
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NPI Number | 1508272139
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Entity Type | Individual
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Provider Name | RYAN H HOLZHAUER M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/03/2014
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 1000 MINERAL POINT AVE
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City | JANESVILLE
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State | WI
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Zip | 53548
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Country | US
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Telephone | 414-303-5678
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Fax |
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Provider Business Mailing Address
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Address Line | 125 N 123RD ST
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City | WAUWATOSA
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State | WI
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Zip | 53226-3809
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Country | US
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Telephone | 414-303-5678
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 65434-20
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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