BENJAMIN GENESIS M BAUTISTA

OSHKOSH, WI
NPI1396051561
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207P00000X Emergency Medicine
(Licence: IL  036130758)
Additional Taxonomies207P00000X Emergency Medicine
(Licence: WI  54794)
Enumeration Date2010-08-26
Last Update Date2017-07-10
Business Address
-- BENJAMIN GENESIS M BAUTISTA MD
855 N WESTHAVEN DR
OSHKOSH, WI 54904-7668
Phone number: 920-456-7400
Mailing Address
-- BENJAMIN GENESIS M BAUTISTA MD
2100 S. MARSHALL BLVD., APT 805
CHICAGO, IL 60623
Phone number: 920-750-3060