Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 39742 | WI |
NPI | 1033100086 |
---|---|
Provider Name | Dana E Rademacher |
First Address | Eau Claire, WI 54702-1510 |
Second Address | Onalaska, WI 54650-2668 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2005 |
Last Update Date | 16/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G01586 | (02) |