Doctor Name: | ANDREA L BEQUEST |
NPI Number: | 1003179839 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA |
License Number: | 2952-23 |
Business Practice Address: | 9200 W Wisconsin Ave Internal Medicine Milwaukee, WI - 532263522 |
Business Phone Number: | 4148056850 |
Business Fax Number: | 4148056851 |
Mailing Address: | 9200 W Wisconsin Ave, Internal Medicine MILWAUKEE |
State: | WI |
Postal Code: | 532263522 |
Phone Number: | 4148056850 |
Fax Number: | 4148056851 |
NPI Enumeration Date: | 06/18/2012 |
NPI Last Update Date: | 02/02/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 2952-23 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |