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NPI Code Detail

MEDICARE: MICHAEL ANTHONY DIDION DO

MEDICARE:   MICHAEL ANTHONY DIDION  DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician19384WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134338841
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL ANTHONY DIDION DO
Provider Business Mailing Address
First Line : 5916 NORTH GREEN BAY AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53209-3810
Country : US
Telephone Number : 262-242-6105
Fax Number : 262-242-5133
Provider Business Practice Location Address
First Line : 3305 S 20TH ST
Second Line : SUITE 150
City : MILWAUKEE
State : WI
Zip : 53215-4941
Country : US
Telephone Number : 414-384-2100
Fax Number : 414-384-2700
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2007
Last Update Date : 12/05/2012

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Directions to “ MICHAEL ANTHONY DIDION DO” Practice Location

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