Individual
TIN NWE OO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
600 HIGHLAND AVE, MADISON, WI 53792-0001
(608) 263-6400
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
50236
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50236
WI STATE LICENSE
WI
Enumeration date
07/19/2007
Last updated
07/25/2011
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