Individual
CLARISSE P ETHRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1821 S STOUGHTON RD, MADISON, WI 53716-2257
(608) 260-6000
(608) 260-6595
Mailing address
1821 S STOUGHTON RD, MADISON, WI 53716-2257
(608) 260-6000
(608) 260-6595
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
36964-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679524243
—
WI
Enumeration date
05/16/2006
Last updated
01/11/2022
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