Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 475 | WI |
Y | 222Z00000X | Podiatrist | 475 | WI |
NPI | 1003891961 |
---|---|
Provider Name | Dr. Alan Kalker |
First Address | Middleton, WI 53562-3485 |
Second Address | Middleton, WI 53562-3485 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2005 |
Last Update Date | 08/12/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
43201600 | (05) | WI |
T62367 | (02) |