Basic Information
Provider Information
NPI: 1447244298
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PAHAPILL
FirstName: PETER
MiddleName: A
NamePrefix: DR.
NameSuffix:  
Credential: MD PHD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9200 W WISCONSIN AVE
Address2: DEPARTMENT OF NEUROSURGERY
City: MILWAUKEE
State: WI
PostalCode: 532263522
CountryCode: US
TelephoneNumber: 4148055400
FaxNumber: 4149550115
Practice Location
Address1: 9200 W WISCONSIN AVE
Address2: DEPARTMENT OF NEUROSURGERY
City: MILWAUKEE
State: WI
PostalCode: 532263522
CountryCode: US
TelephoneNumber: 4148055400
FaxNumber: 4149550115
Other Information
ProviderEnumerationDate: 09/08/2005
LastUpdateDate: 02/22/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207T00000X50551MNN Allopathic & Osteopathic PhysiciansNeurological Surgery 
207T00000X53747WIY Allopathic & Osteopathic PhysiciansNeurological Surgery 

ID Information
IDTypeStateIssuerDescription
5055101MNLICENSE NUMBEROTHER


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