Provider Demographics
NPI:1457387896
Name:AMMON, HELMUT V (MD)
Entity Type:Individual
Prefix:
First Name:HELMUT
Middle Name:V
Last Name:AMMON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:9200 W WISCONSIN AVE
Mailing Address - Street 2:DIVISION OF GASTROENTEROLOGY
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3522
Mailing Address - Country:US
Mailing Address - Phone:414-955-6895
Mailing Address - Fax:414-805-3885
Practice Address - Street 1:9200 W WISCONSIN AVE
Practice Address - Street 2:DIVISION OF GASTROENTEROLOGY
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3522
Practice Address - Country:US
Practice Address - Phone:414-955-6895
Practice Address - Fax:414-805-3885
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI18489207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1457387896Medicaid
WI30139900Medicaid
A78660Medicare UPIN
WI000173645Medicare ID - Type Unspecified