Basic Information
Provider Information
NPI: 1457305708
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LEMEN
FirstName: PAUL
MiddleName: M
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9200 W WISCONSIN AVE
Address2: OBSTETRICS AND GYNECOLOGY
City: MILWAUKEE
State: WI
PostalCode: 532263522
CountryCode: US
TelephoneNumber: 4148056600
FaxNumber: 4148056622
Practice Location
Address1: 9200 W WISCONSIN AVE
Address2: OBSTETRICS AND GYNECOLOGY
City: MILWAUKEE
State: WI
PostalCode: 532263522
CountryCode: US
TelephoneNumber: 4148056600
FaxNumber: 4148056622
Other Information
ProviderEnumerationDate: 05/20/2006
LastUpdateDate: 03/18/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X36172WIY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

ID Information
IDTypeStateIssuerDescription
145730570805WI MEDICAID
009006261U01 HUMANAOTHER


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