Racette, Samuel David

Racette, Samuel David is an individual health care provider with primary practice located at 2801 W Kinnickinnic River Pkwy , Milwaukee WI 53215-3669. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Racette, Samuel David can be contacted via phone (414) 385-1922.

Contact Information

Primary practice address
2801 W Kinnickinnic River Pkwy Milwaukee WI 53215-3669
Phone: (414) 385-1922
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 81935 Wisconsin
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 125069920 Illinois

Profile Details

NPI number 1902347255
LBN Legal business name Racette, Samuel David
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 19th, 2017
Last updated Aug 17th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902347255 NPPES
Wisconsin MEDICAID 100245830

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