Individual
KATHI C MADISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
24098
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0216465
—
IA
01
—
21646
WELLMARK BCBS
IA
Enumeration date
09/06/2005
Last updated
11/27/2007
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