Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 16364 | FL |
N | 207VX0201X | Gynecologic Oncologist | 73981 | WI |
NPI | 1285997239 |
---|---|
Provider Name | Dr. Nitin A Wadhwa |
First Address | De Pere, WI 54115-3316 |
Second Address | Coral Springs, FL 33065-4172 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2012 |
Last Update Date | 13/01/2022 |