Provider Demographics
NPI:1497726392
Name:ZOMPA, JOSEPH MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:MICHAEL
Last Name:ZOMPA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 506
Mailing Address - Street 2:
Mailing Address - City:PEWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53072-0506
Mailing Address - Country:US
Mailing Address - Phone:262-544-3600
Mailing Address - Fax:262-544-3091
Practice Address - Street 1:3000 N GRANDVIEW BLVD
Practice Address - Street 2:W-685
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-1615
Practice Address - Country:US
Practice Address - Phone:262-544-3600
Practice Address - Fax:262-544-3091
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI39831-0202083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine