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NPI Code Detail

MEDICARE: ANDREW ROGER DODD M.D.

MEDICARE: ANDREW ROGER DODD M.D.
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
12086S0122XPlastic and Reconstructive Surgery Physician52441WI

General Provider Information

NPI Number : 1811979156
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW ROGER DODD M.D.
Provider Business Mailing Address
First Line : 36500 AURORA DR
Second Line :
City : SUMMIT
State : WI
Zip : 53066-4899
Country : US
Telephone Number : 262-434-5000
Fax Number :
Provider Business Practice Location Address
First Line : 36500 AURORA DR
Second Line :
City : SUMMIT
State : WI
Zip : 53066-4899
Country : US
Telephone Number : 262-434-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2005
Last Update Date : 12/01/2021

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