Provider Demographics
NPI:1144272485
Name:DENSMORE, EMILY M (MD)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:M
Last Name:DENSMORE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:9000 W WISCONSIN AVE
Mailing Address - Street 2:CHILDREN'S HOSPITAL OF WISCONSIN
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-4874
Mailing Address - Country:US
Mailing Address - Phone:414-337-7050
Mailing Address - Fax:414-337-7860
Practice Address - Street 1:9000 W WISCONSIN AVE
Practice Address - Street 2:CHILDREN'S HOSPITAL OF WISCONSIN
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-4874
Practice Address - Country:US
Practice Address - Phone:414-337-7050
Practice Address - Fax:414-337-7860
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2016-05-05
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Provider Licenses
StateLicense IDTaxonomies
WI44089208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1144272485Medicaid
005806261EOtherHUMANA
WI34341900Medicaid
WI1144272485Medicaid