Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 26286-020 | WI |
NPI | 1003868050 |
---|---|
Provider Name | David K Falk |
First Address | Madison, WI 53713-2334 |
Second Address | Madison, WI 53717-2236 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2006 |
Last Update Date | 12/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003868050 | (05) | WI |
B52697 | (02) |