Provider Demographics
NPI:1598001612
Name:RACZYNSKI, DANIEL MICHAEL (PA-C)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:MICHAEL
Last Name:RACZYNSKI
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2825 N DOWNER AVE
Mailing Address - Street 2:APT D
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53211-3757
Mailing Address - Country:US
Mailing Address - Phone:608-335-8014
Mailing Address - Fax:
Practice Address - Street 1:2414 KOHLER MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081-3129
Practice Address - Country:US
Practice Address - Phone:920-457-4461
Practice Address - Fax:920-459-1483
Is Sole Proprietor?:No
Enumeration Date:2012-12-17
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI3039-23363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant