Provider Demographics
NPI:1114918190
Name:USOW, BARRY H (MD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:H
Last Name:USOW
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2801 W KINNICKINNIC RIVER PKWY
Mailing Address - Street 2:STE 370
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215-3669
Mailing Address - Country:US
Mailing Address - Phone:414-672-6006
Mailing Address - Fax:414-672-6016
Practice Address - Street 1:2801 W KINNICKINNIC RIVER PKWY
Practice Address - Street 2:STE 370
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53215-3669
Practice Address - Country:US
Practice Address - Phone:414-672-6006
Practice Address - Fax:414-672-6016
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI17168208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI30128100Medicaid
WI30128100Medicaid
WIB57268Medicare UPIN