Individual
SAMANTHA EFTEMOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
700 S PARK ST, MADISON, WI 53715-1830
(608) 251-6100
(608) 260-2976
Mailing address
127 N 6TH ST, EVANSVILLE, WI 53536-1054
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8045-23
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346943974
—
WI
Enumeration date
03/23/2023
Last updated
10/25/2024
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