Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | G51428 | WI |
NPI | 1003979030 |
---|---|
Provider Name | Daniel E Tvedten |
First Address | Rhinelander, WI 54501-2852 |
Second Address | Rhinelander, WI 54501-2852 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2006 |
Last Update Date | 15/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
32339000 | (05) | WI |
G51428 | (02) | WI |