Provider Demographics
NPI:1548356967
Name:LAW, BRIAN CHUN-WAH (MD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:CHUN-WAH
Last Name:LAW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9200 W WISCONSIN AVE
Mailing Address - Street 2:DEPARTMENT OF ORTHOPAEDIC SURGERY
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3522
Mailing Address - Country:US
Mailing Address - Phone:414-805-7410
Mailing Address - Fax:414-805-7499
Practice Address - Street 1:6701 ROCKSIDE RD STE 350
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:OH
Practice Address - Zip Code:44131-2351
Practice Address - Country:US
Practice Address - Phone:216-369-2830
Practice Address - Fax:216-642-0070
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI49464-020207X00000X
OH35.148480207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1548356967Medicaid