Most Relevant Information
Provider Data
| NPI Number: | 1003663212 |
| Provider Name: | TEDAN HU HENKEL |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 7972-23 |
Most Important Dates
| Enumeration Date: | 05/06/2024 |
| Last Updated: | 06/27/2024 |
Provider Practice Location
9200 W WISCONSIN AVE
MILWAUKEE
WI
532263522
Practice Location Phone/Fax
| Phone: | 4148056400 |
| Fax: | 4049550213 |
Provider Mailing Location
9200 W WISCONSIN AVE
MILWAUKEE
WI
532263522
Provider Mailing Phone/Fax
| Phone: | 4148056400 |
| Fax: | 4149550213 |