Individual
NIKA TAVBERIDZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
600 HIGHLAND AVE, MADISON, WI 53792-1465
(608) 263-8443
(608) 262-7174
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
81986-20
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/28/2021
Last updated
06/14/2024
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