Basic Information
Provider Information
NPI: 1912045097
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BURROWS
FirstName: PATRICIA
MiddleName: E
NamePrefix:  
NameSuffix:  
Credential: M.D.,
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9000 W WISCONSIN AVE
Address2: MS 721
City: MILWAUKEE
State: WI
PostalCode: 532264874
CountryCode: US
TelephoneNumber: 4142668567
FaxNumber: 4142661525
Practice Location
Address1: 9000 W WISCONSIN AVE
Address2: MS 721
City: MILWAUKEE
State: WI
PostalCode: 532264874
CountryCode: US
TelephoneNumber: 4142668567
FaxNumber: 4142661525
Other Information
ProviderEnumerationDate: 02/02/2007
LastUpdateDate: 08/28/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2086S0129X238811-1NYY Allopathic & Osteopathic PhysiciansSurgeryVascular Surgery

No ID Information.


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