Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 21911 | WI |
Y | 207RP1001X | Pulmonary Disease | 21911 | WI |
NPI | 1063461606 |
---|---|
Provider Name | Mark S Lingenfelter |
First Address | Madison, WI 53703-3356 |
Second Address | Madison, WI 53703 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2006 |
Last Update Date | 04/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000560 | BLUE CROSS (01) | ME |
110046890 | RAILROAD MEDICARE (01) | ME |
332530099 | (05) | ME |
8CE373 | BCBS (01) | TX |
8L22974 | (02) | TX |
E10013 | (02) |