Individual
KIM LYNNETTE DITTUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, PHD
Contact information
Practice address
600 HIGHLAND AVE, MADISON, WI 53792-1742
(608) 265-1700
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
Primary
83937-20
WI
207RH0003X
Hematology & Oncology Physician
060-0003262
VT
207RH0003X
Hematology & Oncology Physician
83937-20
WI
207RX0202X
Medical Oncology Physician
83937-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60600003262
PHYSICIAN LIMITED TEMP LI
VT
Enumeration date
05/17/2007
Last updated
06/24/2024
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