William Gunther Mallon CRNA

NPI 1013090885 - Nurse Anesthetist, Certified Registered - 367500000X

NPI Details
NPI 1013090885
Gender Male
Enumeration Date 10/23/2006
Last Updated 03/22/2010
Entity Type Individual
Active Over 10 years ago
Practice Location
2149 FOUND LAKE RD. BOX 625
SAINT GERMAIN WI, 54558-0625, US
Phone (715) 542-2728
Fax
Business Location
PO BOX 625
SAINT GERMAIN WI, 54558-0625, US
Phone (715) 542-2728
Fax
Toxanomy
Taxonomy Code 367500000X
License State Wisconsin
License Number 137583-030
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According to our database, William Gunther Mallon CRNA NPI is 1013090885, taxonomy code is 367500000X and license number is 137583-030, license state is located at Wisconsin. William Gunther Mallon CRNA physically located at 2149 Found Lake Rd. Box 625, Saint Germain WI, 54558-0625. NPI Number William Gunther Mallon CRNA has the Individual type.

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1013090885 NPI number is provided on an as is basis without warranty of any kind. 1013090885 is maintained by the National Plan & Provider Enumeration System. The contents of William Gunther Mallon CRNA are for informational purposes only.