MEDICARE: KIMBERLY VIDMAR

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
1	2080P0205X	Pediatric Endocrinology Physician	81889-20	WI

General Provider Information

NPI Number	:	1689203440
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY VIDMAR

Provider Business Mailing Address
First Line	:	600 HIGHLAND AVE
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53792-0001
Country	:	US
Telephone Number	:	608-263-0572
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 HIGHLAND AVE
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53792-3098
Country	:	US
Telephone Number	:	608-263-0572
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2020
Last Update Date	:	06/01/2026

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Directions to “ KIMBERLY VIDMAR ” Practice Location

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