Organization
TARA L. PASSOW MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARA L PASSOW M.D. (PRESIDENT)
(920) 885-2622
Entity
Organization
Contact information
Practice address
700 HILLCREST CT, BEAVER DAM, WI 53916-2418
(920) 885-2622
(920) 885-4419
Mailing address
700 HILLCREST CT, BEAVER DAM, WI 53916-2418
(920) 885-2622
(920) 885-4419
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
24736
WI
Other
Enumeration date
08/23/2007
Last updated
03/26/2009
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