Individual
DARRYL M WASHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
16641
MN
2085R0202X
Diagnostic Radiology Physician
Primary
17157
WI
2085R0202X
Diagnostic Radiology Physician
26079
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30861700
—
WI
Enumeration date
06/10/2005
Last updated
07/08/2007
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