Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 31543 | WI |
Y | 208600000X | Surgeon | 31543 | WI |
NPI | 1013971662 |
---|---|
Provider Name | Michael J Garren |
First Address | Middleton, WI 53562-5531 |
Second Address | Madison, WI 53715 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2006 |
Last Update Date | 30/12/2020 |