Provider Demographics
NPI:1700174554
Name:MEIER, LUCINDA RAE (DPM)
Entity Type:Individual
Prefix:
First Name:LUCINDA
Middle Name:RAE
Last Name:MEIER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:LUCINDA
Other - Middle Name:RAE
Other - Last Name:MALVITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10125 W NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-2426
Mailing Address - Country:US
Mailing Address - Phone:414-257-0676
Mailing Address - Fax:
Practice Address - Street 1:3610 MICHELLE WITMER MEMORIAL DR
Practice Address - Street 2:SUITE 110
Practice Address - City:NEW BERLIN
Practice Address - State:WI
Practice Address - Zip Code:53151-5292
Practice Address - Country:US
Practice Address - Phone:262-821-1588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-14
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1042-25213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist