Provider Demographics
NPI:1669404968
Name:JUAREZ, JOE M (MD)
Entity type:Individual
Prefix:DR
First Name:JOE
Middle Name:M
Last Name:JUAREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:W180N8085 TOWN HALL RD
Mailing Address - Street 2:DEPARTMENT OF ANESTHESIOLOGY
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-3518
Mailing Address - Country:US
Mailing Address - Phone:262-257-5100
Mailing Address - Fax:
Practice Address - Street 1:W180N8085 TOWN HALL RD
Practice Address - Street 2:DEPARTMENT OF ANESTHESIOLOGY
Practice Address - City:MENOMONEE FALLS
Practice Address - State:WI
Practice Address - Zip Code:53051-3518
Practice Address - Country:US
Practice Address - Phone:262-257-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036106697207L00000X
WI51130207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036106697Medicaid
091100OtherHEALTH ALLIANCE
WI1669404968Medicaid
H97962Medicare UPIN
WI1669404968Medicaid
IL036106697Medicaid