Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 39998 | WI |
N | 207VX0000X | Obstetrician | 321547 | LA |
NPI | 1427168582 |
---|---|
Provider Name | Suzanne M Welsch |
First Address | Sauk City, WI 53583-1101 |
Second Address | Sauk City, WI 53583-1101 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 17/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1B4705 | MEDICARE (01) | LA |
321547 | MEDICAL LICENSE (01) | LA |
32445600 | (05) | WI |
G70360 | (02) |