Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 67201 | WI |
N | 2086S0120X | Pediatric Surgery | 67201-20 | WI |
NPI | 1528321122 |
---|---|
Provider Name | Shivani Garg |
First Address | Middleton, WI 53562-5531 |
Second Address | Madison, WI 53715-1375 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2012 |
Last Update Date | 14/01/2021 |