Individual
MICHAEL G LANDGRAF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
20 PARK STREET, STE #360, MADISON, WI 53715
(608) 257-2208
Mailing address
20 PARK STREET, STE #360, MADISON, WI 53715
(608) 257-2208
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
91549-30
WI
367H00000X
Anesthesiologist Assistant
231-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659333201
—
WI
Enumeration date
04/06/2006
Last updated
12/27/2020
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