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1124002654
DJERRICK CU TAN
MEQUON, WI
NPI
1124002654
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2085R0202X Radiology Diagnostic Radiology
(Licence: WI 47802)
Enumeration Date
2005-11-29
Last Update Date
2023-11-17
Business Address
DJERRICK CU TAN M.D.
10945 N PORT WASHINGTON RD STE 201
MEQUON, WI 53092-5078
Phone number: 262-292-3151
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Mailing Address
DJERRICK CU TAN M.D.
10945 N PORT WASHINGTON RD STE 201
MEQUON, WI 53092-5078
Phone number: 262-292-3151
Copy
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