Dahlstrom, Elijah
Dahlstrom, Elijah is an individual health care provider with primary practice located at 9200 W Wisconsin Ave , Milwaukee WI 53226-3522. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Dahlstrom, Elijah can be contacted via phone (414) 955-6450.Contact Information
Primary practice address
9200 W Wisconsin Ave
Milwaukee WI 53226-3522
Phone: (414) 955-6450
Fax: (414) 955-0082
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 81642-20 | Wisconsin |
Profile Details
| NPI number | 1063038651 |
|---|---|
| LBN Legal business name | Dahlstrom, Elijah |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 19th, 2020 |
| Last updated | Jul 5th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063038651 | NPPES |
| Wisconsin | MEDICAID | 1063038651 |
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