Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 66070 | WI |
Y | 208200000X | Surgeon | 66070 | WI |
Y | 208600000X | Surgeon | 66070 | WI |
NPI | 1144648346 |
---|---|
Provider Name | Juan Sebastian Danobeitia |
First Address | Middleton, WI 53562-5531 |
Second Address | Madison, WI 53792-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2014 |
Last Update Date | 22/09/2021 |