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General NPI Number Information
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NPI Number | 1851365506
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Entity Type | Individual
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Provider Name | DIMA ADL MD
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Gender | Female
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Dates
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Enumeration Date | 02/16/2006
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Last Update Date | 11/07/2016
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Provider Practice Location Address
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Address Line | 2350 N LAKE DRIVE SUITE 302
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City | MILWAUKEE
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State | WI
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Zip | 53211-4528
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Country | US
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Telephone | 414-298-7104
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Fax | 414-298-7117
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Provider Business Mailing Address
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Address Line | 788 N JEFFERSON ST SUITE 300/ATTN. KAAREN BUTZEN
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City | MILWAUKEE
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State | WI
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Zip | 53202-3718
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Country | US
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Telephone | 414-272-8950
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Fax | 414-272-0859
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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 | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | 50804
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 50804
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 50804
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License Number State | WI
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