Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 42007 | WI |
NPI | 1861445512 |
---|---|
Provider Name | Dr. William Rhead |
First Address | Middleton, WI 53562-5531 |
Second Address | Madison, WI 53705 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2006 |
Last Update Date | 11/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
008000215D | HUMANA (01) | |
1861445512 | (05) | WI |
A01404 | (02) |