Individual
GABINO MANUEL MARIANO MAZA RODAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1685 HIGHLAND AVE, MADISON, WI 53705-2281
(608) 265-7593
Mailing address
749 UNIVERSITY ROW STE 200, MADISON, WI 53705-1465
(708) 783-3400
(708) 783-3341
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
75118-20
WI
390200000X
Student in an Organized Health Care Education/Training Program
125.072445
IL
Other
Enumeration date
04/11/2018
Last updated
06/18/2021
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