Healthcare Provider Details

I. General information

NPI: 1487216560
Provider Name (Legal Business Name): SOMTO TAGBO NWAEDOZIE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2019
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UW HOSPITALS & CLINICS 600 HIGHLAND AVE
MADISON WI
53792-5703
US

IV. Provider business mailing address

UW HOSPITALS & CLINICS 600 HIGHLAND AVE
MADISON WI
53792-0001
US

V. Phone/Fax

Practice location:
  • Phone: 608-263-6400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0001X
TaxonomyAdvanced Heart Failure and Transplant Cardiology Physician
License Number73893-20
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number73893
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: