Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 32290-020 | WI |
N | 208600000X | Surgeon | 32290-020 | WI |
Y | 2086S0120X | Pediatric Surgery | 32290-020 | WI |
NPI | 1609833383 |
---|---|
Provider Name | Leonard L Go |
First Address | Madison, WI 53715-1830 |
Second Address | Madison, WI 53715-1830 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2006 |
Last Update Date | 02/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
32435700 | (05) | WI |
6314 | DEAN HEALTH INSURANCE (01) | WI |
G72772 | (02) |