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NPI Code Detail

MEDICARE: EMERGENCY MEDICINE ASSOCIATES OF MADISON, SC

MEDICARE: EMERGENCY MEDICINE ASSOCIATES OF MADISON, SC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1235119769
Entity Type Code : Organization
Provider Name (Legal Business Name) : EMERGENCY MEDICINE ASSOCIATES OF MADISON, SC
Provider Business Mailing Address
First Line : PO BOX 628156
Second Line :
City : MIDDLETON
State : WI
Zip : 53562-8156
Country : US
Telephone Number : 608-556-5402
Fax Number :
Provider Business Practice Location Address
First Line : 202 S PARK ST
Second Line :
City : MADISON
State : WI
Zip : 53715-1507
Country : US
Telephone Number : 608-417-4300
Fax Number : 608-417-6051
Authorized Official
Title or Position : PRESIDENT
Name : KARL A NIBBELINK
Credential : MD
Telephone Number : 608-556-5402
Provider Enumeration Date : 01/19/2006
Last Update Date : 12/09/2025

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Directions to “EMERGENCY MEDICINE ASSOCIATES OF MADISON, SC ” Practice Location

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