Provider Demographics
NPI:1811942444
Name:HASELOW, WILLIAM C (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:C
Last Name:HASELOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 E WISCONSIN AVE
Mailing Address - Street 2:SUITE 2000
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-4815
Mailing Address - Country:US
Mailing Address - Phone:414-290-6720
Mailing Address - Fax:414-290-6755
Practice Address - Street 1:900 W CLAIREMONT AVE
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-6122
Practice Address - Country:US
Practice Address - Phone:414-290-6715
Practice Address - Fax:414-290-6755
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI30013-020207P00000X
WI30013-20207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI930068403OtherMEDICARE RAILROAD
WI31809700Medicaid
WI930072839OtherMEDICARE RAILROAD
WI930046182OtherMEDICARE RAILROAD
WI000668655Medicare ID - Type Unspecified
WI002032280Medicare ID - Type Unspecified
WI001707660Medicare ID - Type Unspecified
F25317Medicare UPIN
WI001132350Medicare ID - Type Unspecified
WI31809700Medicaid