Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 69931-20 | WI |
NPI | 1154664100 |
---|---|
Provider Name | Dayton M Opel |
First Address | Madison, WI 53716-2257 |
Second Address | Madison, WI 53716-2257 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2013 |
Last Update Date | 27/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1154664100 | (05) | WI |