Individual
MICAH MAE LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3209 DRYDEN DR, MADISON, WI 53704-3015
(608) 241-9020
(608) 274-0310
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
83153
WI
Other
Enumeration date
04/08/2022
Last updated
08/27/2025
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