Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 31249 | WI |
N | 208000000X | Pediatrician | 31249 | WI |
NPI | 1043288921 |
---|---|
Provider Name | David S Wargowski |
First Address | Middleton, WI 53562-5531 |
Second Address | Madison, WI 53705 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2006 |
Last Update Date | 09/12/2021 |