Individual
FIATSOGBE SETUTSI DZUALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4621 EASTPARK BLVD, MADISON, WI 53718-2000
(608) 914-0300
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
85958-20
WI
Other
Enumeration date
04/04/2020
Last updated
09/22/2025
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