Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 25618 | WI |
NPI | 1477517035 |
---|---|
Provider Name | Munci Kalayoglu |
First Address | Madison, WI 53717 |
Second Address | Madison, WI 53792 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
30547600 | (05) | WI |
B53970 | (02) |