Individual
NICOLE DODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
733 W CLAIREMONT AVE, EAU CLAIRE, WI 54701-6101
(715) 838-5222
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(715) 838-5222
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
28771
MN
208800000X
Urology Physician
Primary
22846
WI
208800000X
Urology Physician
28771
MN
208800000X
Urology Physician
65130
MN
Other
Enumeration date
06/21/2017
Last updated
08/01/2022
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