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DR. MARY EAPEN MD

Pediatric Hematology-Oncology >> Pediatrics >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1306897210

Individual Registrant:
DR. MARY  EAPEN MD
Gender: F
Not Sole Proprietor

Location and contact information for practice:
9000 W WISCONSIN AVE DIVISION OF PEDIATRIC HEMATOLOGY/ONCOLOGY MILWAUKEE, WI 53226-4874 US
Tel: 414-456-4170  Fax: 414-456-6543

Contact information for business:
9000 W WISCONSIN AVE DIVISION OF PEDIATRIC HEMATOLOGY/ONCOLOGY MILWAUKEE, WI 53226-4874 US
Tel: 414-456-4170  Fax: 414-456-6543

Registration Information:
NPI: 1306897210
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y2080P0207XAllopathic & Osteopathic Physicians
Pediatrics
Pediatric Hematology-Oncology
WI42290

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
1306897210WI05
HUMANA008000315L01




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