Provider Demographics
NPI:1073787719
Name:DAY, CAROLYN K (MD)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:K
Last Name:DAY
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Gender:F
Credentials:MD
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Mailing Address - Street 1:717 W MORELAND BLVD
Mailing Address - Street 2:PROHEALTH CARE MEDICAL ASSOCIATES INC
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-2432
Mailing Address - Country:US
Mailing Address - Phone:262-542-9100
Mailing Address - Fax:262-542-7366
Practice Address - Street 1:717 W MORELAND BLVD
Practice Address - Street 2:PROHEALTH CARE MEDICAL ASSOCIATES INC
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-2432
Practice Address - Country:US
Practice Address - Phone:262-542-9100
Practice Address - Fax:262-542-7366
Is Sole Proprietor?:No
Enumeration Date:2008-04-14
Last Update Date:2023-11-03
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Provider Licenses
StateLicense IDTaxonomies
OH35.138481207Q00000X
WI54214207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI683750594Medicare PIN