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Michael D Hazelberg, DO

Family Medicine in West Allis, WI. Individual provider (NPI-1).

NPI number1013051069
StatusActive
Last updated in NPPESJul 24, 2018

Details

NPI
1013051069
Entity type
Individual (NPI-1)
Name
Michael D Hazelberg
Credential
DO
Sex
Male
Sole proprietor
No
Enumeration date
Feb 16, 2007
Last updated
Jul 24, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine50451-21WIYes

Practice location

2514 S 102nd St Ste 160
West Allis, WI 53227-2142

Phone 414-255-0300 · Fax 414-543-9601

Mailing address

2514 S 102nd St Ste 160
West Allis, WI 53227-2142

Other practice locations

360 S Mountin Dr
Mayville, WI 53050-1498

Phone 920-387-7500 · Fax 920-387-7596

360 S Mountin Dr
Mayville, WI 53050-1498

Phone 920-387-7500 · Fax 920-387-7596

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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Family Medicine Physician providers in West Allis, WI

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