Individual
NISSAGE CADET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1905 E HUEBBE PKWY, BELOIT CLINIC, BELOIT, WI 53511-1842
(608) 364-2400
(608) 363-7376
Mailing address
1905 E HUEBBE PKWY, BELOIT HEALTH SYSTEM INC., BELOIT, WI 53511-1842
(608) 364-2293
(608) 364-5452
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036-142234
IL
208600000X
Surgery Physician
Primary
66894-20
WI
208600000X
Surgery Physician
79276
MA
2086S0129X
Vascular Surgery Physician
036-142234
IL
2086S0129X
Vascular Surgery Physician
66894-20
WI
Other
Enumeration date
10/27/2006
Last updated
02/20/2017
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