Provider Demographics
NPI:1083609739
Name:DONOHOUE, PATRICIA A (MD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:A
Last Name:DONOHOUE
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:9000 W WISCONSIN AVE
Mailing Address - Street 2:PEDIATRIC ENDOCRINOLOGY
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-4874
Mailing Address - Country:US
Mailing Address - Phone:414-266-6750
Mailing Address - Fax:414-266-6749
Practice Address - Street 1:9000 W WISCONSIN AVE
Practice Address - Street 2:PEDIATRIC ENDOCRINOLOGY
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-4874
Practice Address - Country:US
Practice Address - Phone:414-266-6750
Practice Address - Fax:414-266-6749
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI515822080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0299909Medicaid
IA29990OtherWELLMARK BCBS
WI1083609739Medicaid
WI1083609739Medicaid
WI73601 2317Medicare PIN
WI602550064Medicare PIN
IA29990OtherWELLMARK BCBS