Provider Demographics
NPI:1811076516
Name:BERRY-HOOKS, MAISHA (MD)
Entity type:Individual
Prefix:
First Name:MAISHA
Middle Name:
Last Name:BERRY-HOOKS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 78600
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53278-1082
Mailing Address - Country:US
Mailing Address - Phone:414-955-5156
Mailing Address - Fax:414-955-6082
Practice Address - Street 1:1700 W PARADISE DR
Practice Address - Street 2:
Practice Address - City:WEST BEND
Practice Address - State:WI
Practice Address - Zip Code:53095
Practice Address - Country:US
Practice Address - Phone:262-334-3451
Practice Address - Fax:262-347-3044
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI51235207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine