Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 45633 | WI |
Y | 2080P0201X | Pediatric Allergist | 45633 | WI |
N | 2080P0216X | Pediatric Rheumatologist | 45633 | WI |
NPI | 1053387704 |
---|---|
Provider Name | Christine M Seroogy |
First Address | Middleton, WI 53562-5531 |
Second Address | Madison, WI 53717 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2006 |
Last Update Date | 20/01/2021 |