Dantuma, Mark William

Dantuma, Mark William is an individual health care provider with primary practice located at 3200 E Racine St , Janesville WI 53546-2343. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Dantuma, Mark William can be contacted via phone (608) 371-8000.

Contact Information

Primary practice address
3200 E Racine St Janesville WI 53546-2343
Phone: (608) 371-8000
Fax: (608) 371-8939
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 8782-33 Wisconsin

Profile Details

NPI number 1407322084
LBN Legal business name Dantuma, Mark William
Credentials APNP
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 22nd, 2018
Last updated Nov 6th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407322084 NPPES
Wisconsin MEDICAID 1407322084

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