Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | 28289 | WI |
NPI | 1225098676 |
---|---|
Provider Name | Karl F Szewczyk |
First Address | Madison, WI 53715-1849 |
Second Address | Madison, WI 53715-1849 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
31615800 | (05) | WI |