Provider Demographics
NPI:1760674675
Name:LOUVAR-CANGA, CLAIRE (DO)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:
Last Name:LOUVAR-CANGA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:CLAIRE
Other - Middle Name:
Other - Last Name:LOUVAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:4455 S 108TH ST
Mailing Address - Street 2:GREENFIELD HIGHLANDS WALK-IN CLINIC
Mailing Address - City:GREENFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53228-2504
Mailing Address - Country:US
Mailing Address - Phone:414-427-5350
Mailing Address - Fax:414-427-5311
Practice Address - Street 1:4455 S 108TH ST
Practice Address - Street 2:GREENFIELD HIGHLANDS WALK-IN CLINIC
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53228-2504
Practice Address - Country:US
Practice Address - Phone:414-427-5350
Practice Address - Fax:414-427-5311
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2013-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI42294207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1760674675Medicaid
WI68086 2639Medicare PIN
WI73601 2642Medicare PIN