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Individual

CAROL DIANE STODOLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1040 DIVISION ST, MAUSTON, WI 53948-1931
(608) 847-5000
Mailing address
1040 DIVISION ST, MAUSTON, WI 53948-1931

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
24042
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30529100
WI
Enumeration date
10/28/2005
Last updated
07/08/2007
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