Provider Demographics
NPI:1609859651
Name:AMUZU, JOHN K (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:K
Last Name:AMUZU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4025 N 92ND ST
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53222-1613
Mailing Address - Country:US
Mailing Address - Phone:414-358-5420
Mailing Address - Fax:
Practice Address - Street 1:8901 W LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53227
Practice Address - Country:US
Practice Address - Phone:414-328-6000
Practice Address - Fax:414-649-1328
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI32169207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P0037869OtherRAIL ROAD MEDICARE
WI31735500Medicaid
WI0028-01988Medicare PIN
WI0024-73375Medicare PIN
WI0021-46195Medicare PIN
WIF43338Medicare UPIN
WI0028-46500Medicare PIN