Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 52341-20 | WI |
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 52341-20 | WI |
NPI | 1184828170 |
---|---|
Provider Name | Dr. Scott R Chaiet |
First Address | Middleton, WI 53562-5531 |
Second Address | Madison, WI 53792-3409 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2007 |
Last Update Date | 15/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
264093-1 | STATE LICENSE (01) | NY |
52341-20 | STATE LICENSE (01) | WI |