Organization
MD21 GLOBAL
Active
Other names
AvanceMD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TARA DALL MD (MEDICAL DIRECTOR)
(888) 498-5296
Entity
Organization
Contact information
Practice address
601 GENESEE ST UNIT 303, DELAFIELD, WI 53018-1410
(888) 498-5296
(888) 495-8194
Mailing address
601 GENESEE ST UNIT 303, DELAFIELD, WI 53018-1410
(888) 498-5296
(888) 495-8194
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
09/19/2022
Last updated
09/19/2022
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