Individual
MR. NICHOLAS SUYDAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, PA-C, ATC
Contact information
Practice address
1211 FISH HATCHERY RD, MADISON, WI 53715-1909
(608) 252-8000
(608) 288-6490
Mailing address
1211 FISH HATCHERY RD, MADISON, WI 53715-1909
(608) 252-8000
(608) 288-6490
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7885-23
WI
363AS0400X
Surgical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669837381
—
WI
Enumeration date
12/22/2015
Last updated
11/13/2024
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