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Contact Information

ALEXANDRA D DISRUD, PA-C
36500 AURORA DR
SUMMIT, WI53066
 Phone: 262-434-1000
 Fax: 262-434-5050
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for ALEXANDRA D DISRUD · (Female)

NPI Number 1053831487
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 06/27/2017
Last updated 12/01/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • WI Medicaid 1053831487
Hospital affiliation(s)
  • AURORA MEDICAL CENTER - (Acute Care)
    36500 AURORA DRIVE
    SUMMIT, WI 53066
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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