Provider Demographics
NPI:1245785104
Name:VOGEL, RICHARD (PHD, DABNM)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:VOGEL
Suffix:
Gender:M
Credentials:PHD, DABNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 W BROWN DEER RD # 240
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53217-2372
Mailing Address - Country:US
Mailing Address - Phone:215-534-4115
Mailing Address - Fax:
Practice Address - Street 1:333 W BROWN DEER RD # 240
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53217-2372
Practice Address - Country:US
Practice Address - Phone:414-351-6666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-22
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist