Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 67508 | WI |
N | 208200000X | Surgeon | 67508 | WI |
N | 208600000X | Surgeon | 67508 | WI |
NPI | 1093224776 |
---|---|
Provider Name | David P Al-Adra |
First Address | Middleton, WI 53562-5531 |
Second Address | Madison, WI 53792-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2017 |
Last Update Date | 28/01/2021 |