Healthcare Provider Details

I. General information

NPI: 1548214349
Provider Name (Legal Business Name): HEIDI M EIMERMANN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 01/28/2021
Certification Date: 01/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3330 UNIVERSITY AVE STE 205
MADISON WI
53705-2167
US

IV. Provider business mailing address

3330 UNIVERSITY AVE STE 205
MADISON WI
53705-2167
US

V. Phone/Fax

Practice location:
  • Phone: 608-333-1663
  • Fax:
Mailing address:
  • Phone: 608-333-1663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number37468-020
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: