Individual
JILL M MASANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4410 REGENT ST, MADISON, WI 53705-4901
(608) 233-9746
(608) 236-1981
Mailing address
4410 REGENT ST, MADISON, WI 53705-4901
(608) 233-9746
(608) 236-1981
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
60542-20
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1700174091
—
WI
Enumeration date
07/20/2011
Last updated
09/01/2015
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