Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 4222-012 | WI |
NPI | 1174578942 |
---|---|
Provider Name | Dr. Donald Joseph Pfau |
First Address | Sauk City, WI 53583-1463 |
Second Address | Sauk City, WI 53583-1463 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2006 |
Last Update Date | 19/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
38968000 | (05) | WI |