Individual
TAPUWA D MATONDO
Active
Individual
TAPUWA D MATONDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
75852
WI
390200000X
Student in an Organized Health Care Education/Training Program
RS 2014-0989
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780073742
—
WI
Enumeration date
01/14/2015
Last updated
10/23/2023
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