Provider Demographics
NPI:1437211539
Name:PRAHL, JAMES DANIEL (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DANIEL
Last Name:PRAHL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2900 WEST OKLAHOMA AVE
Mailing Address - Street 2:2ND FLOOR GALLERIA
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215
Mailing Address - Country:US
Mailing Address - Phone:414-649-6572
Mailing Address - Fax:414-649-5815
Practice Address - Street 1:2900 WEST OKLAHOMA AVE
Practice Address - Street 2:2ND FLOOR GALLERIA
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53215
Practice Address - Country:US
Practice Address - Phone:414-649-6572
Practice Address - Fax:414-649-5815
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2021-12-01
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Provider Licenses
StateLicense IDTaxonomies
WI49725-020207R00000X, 207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1437211539Medicaid
WI1437211539Medicaid