Doctor Name: | DR. ELANA FRAN WISTROM |
NPI Number: | 1134376486 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DO |
License Number: | 5101017794 |
Business Practice Address: | 2825 Prairie Ave Beloit, WI - 535111844 |
Business Phone Number: | 6083635500 |
Business Fax Number: | 6083635539 |
Mailing Address: | 2825 Prairie Ave, BELOIT |
State: | WI |
Postal Code: | 535111844 |
Phone Number: | 6083635500 |
Fax Number: | 6083635539 |
NPI Enumeration Date: | 08/19/2008 |
NPI Last Update Date: | 01/21/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207V00000X |
License Number: | 5101017794 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Obstetrics & Gynecology |
Taxonomy Specialization: | |
Taxonomy Definition: | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |