Provider Demographics
NPI:1801864467
Name:LUDWIKOWSKI, AMY M (MD)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:M
Last Name:LUDWIKOWSKI
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:431 E CLAIREMONT AVE STE C
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-6480
Mailing Address - Country:US
Mailing Address - Phone:715-514-5724
Mailing Address - Fax:
Practice Address - Street 1:431 E CLAIREMONT AVE STE C
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-6480
Practice Address - Country:US
Practice Address - Phone:715-514-5724
Practice Address - Fax:715-514-5734
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2021-12-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI42649207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1801864467Medicaid
MN1801864467Medicaid
WI1801864467Medicaid
WI004880203Medicare PIN