Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 29663-021 | WI |
N | 111NI0900X | Internist | 29663-021 | WI |
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 29663-021 | WI |
NPI | 1073578076 |
---|---|
Provider Name | Paul M Reber |
First Address | Madison, WI 53715-1911 |
Second Address | Madison, WI 53715-1911 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2006 |
Last Update Date | 04/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
30048600 | (05) | WI |
4737 | DEAN HEALTH INSURANCE (01) | WI |
F05697 | (02) |