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Individual

STEPHANE L DESOUCHES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
600 HIGHLAND AVE, MADISON, WI 53792-0001
(608) 263-9729
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
69352
WI
2085R0202X
Diagnostic Radiology Physician
DO-04992
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1083970602
WI
Enumeration date
04/09/2012
Last updated
04/07/2025
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