Individual
MR. DANA DECKER DOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
515 22ND AVE, MONROE, WI 53566-1569
(608) 324-1454
Mailing address
515 22ND AVE, MONROE, WI 53566-1569
(608) 324-1454
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
34.009283
OH
207L00000X
Anesthesiology Physician
Primary
54481
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255545695
—
WI
05
—
3041685
—
OH
01
—
54481
WI STATE LIC
WI
Enumeration date
05/09/2007
Last updated
06/08/2022
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