Individual
MARGARET I FAGERHOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
202 S PARK ST, MADISON, WI 53715-1507
(608) 267-6090
(608) 417-6281
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
(608) 829-5485
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
26122
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0158-13125
MEDICARE ID-TYPE UNSPECIFIED
WI
01
—
300116508
RAILROAD MEDICARE
WI
Enumeration date
03/14/2006
Last updated
02/04/2009
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