Provider Demographics
NPI:1922024249
Name:CUETO, JANE-LORELIE P (MD)
Entity type:Individual
Prefix:DR
First Name:JANE-LORELIE
Middle Name:P
Last Name:CUETO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JANE
Other - Middle Name:P
Other - Last Name:CUETO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:9200 W WISCONSIN AVE
Mailing Address - Street 2:DEPARTMENT OF ANESTHESIOLOGY
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3522
Mailing Address - Country:US
Mailing Address - Phone:414-890-5870
Mailing Address - Fax:414-259-1522
Practice Address - Street 1:9200 W WISCONSIN AVE
Practice Address - Street 2:DEPARTMENT OF ANESTHESIOLOGY
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3522
Practice Address - Country:US
Practice Address - Phone:414-890-5870
Practice Address - Fax:414-259-1522
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005013748207L00000X
WI51836207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO207286600Medicaid
WI1922024249Medicaid
I40485Medicare UPIN
MO207286600Medicaid