Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 35082-20 | WI |
NPI | 1447225933 |
---|---|
Provider Name | John Edward Downs |
First Address | Madison, WI 53711-2022 |
Second Address | Madison, WI 53711-2022 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2006 |
Last Update Date | 14/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E98130 | (02) |