Staller, Bernard J

Staller, Bernard J is an individual health care provider with primary practice located at 2801 W Kinnickinnic River Pkwy Suite 840, Milwaukee WI 53215-3669. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Staller, Bernard J can be contacted via phone (414) 649-3530.

Contact Information

Primary practice address
2801 W Kinnickinnic River Pkwy Suite 840 Milwaukee WI 53215-3669
Phone: (414) 649-3530
Fax: (414) 649-3551
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 18507 Wisconsin
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 18507-020 Wisconsin

Profile Details

NPI number 1700886686
LBN Legal business name Staller, Bernard J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 21st, 2005
Last updated Aug 31st, 2009 - about 17 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 1700886686 NPPES
Wisconsin MEDICAID 30239700

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