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Individual

LEIF LAMONT PAULSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1 SCIENCE CT, MADISON, WI 53711-1055
(608) 284-6360
(608) 284-6375
Mailing address
1 SCIENCE CT, MADISON, WI 53711-1055
(608) 284-6360
(608) 284-6375

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
57752-20
WI
207Q00000X
Family Medicine Physician
MD52028
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1861552119
BCBSWI
WI
05
1861552119
WI
01
PAULSLEI
MERCYCARE INSURANACE
WI
Enumeration date
12/09/2006
Last updated
01/06/2016
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