Individual
DANIEL A WALLNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
752 N HIGH POINT RD, MADISON, WI 53717-2236
(608) 824-4000
(608) 824-4919
Mailing address
752 N HIGH POINT RD, MADISON, WI 53717-2236
(608) 824-4000
(608) 824-4919
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
275-23
WI
363AM0700X
Medical Physician Assistant
275-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1609822543
—
WI
Enumeration date
05/25/2006
Last updated
12/15/2020
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