Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 60134-20 | WI |
NPI | 1376747154 |
---|---|
Provider Name | Michael D. Rizzari |
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 | 13/06/2007 |
Last Update Date | 13/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
BP1-0026544 | INSTITUTIONAL PERMIT (01) |