Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 57.020726 | OH |
N | 111NI0900X | Internist | 57.020726 | OH |
N | 207RH0000X | Hematologist | 59216 | MN |
N | 207RH0003X | Hematology & Oncology | 59216 | MN |
Y | 207RH0003X | Hematology & Oncology | 70768 | WI |
NPI | 1245598101 |
---|---|
Provider Name | Dr. Priyanka A Pophali |
First Address | Middleton, WI 53562-5531 |
Second Address | Madison, WI 53792-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2012 |
Last Update Date | 19/01/2021 |