Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 23140-020 | WI |
Y | 208600000X | Surgeon | 23140-020 | WI |
N | 2086S0105X | Surgery of the Hand | 23140-020 | WI |
NPI | 1699761130 |
---|---|
Provider Name | Dr. Rodney W Malinowski |
First Address | Mauston, WI 53948-1931 |
Second Address | Mauston, WI 53948-1931 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2005 |
Last Update Date | 13/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
30369300 | (05) | WI |
B54778 | (02) | WI |