Healthcare Provider Details

I. General information

NPI: 1023079811
Provider Name (Legal Business Name): DONALD A CARUFEL-WERT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 05/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 KNUTSON DR
MADISON WI
53704-1133
US

IV. Provider business mailing address

317 KNUTSON DR
MADISON WI
53704-1133
US

V. Phone/Fax

Practice location:
  • Phone: 608-301-9231
  • Fax: 608-223-7727
Mailing address:
  • Phone: 608-301-9231
  • Fax: 608-223-7727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34593-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: