Healthcare Provider Details

I. General information

NPI: 1245206317
Provider Name (Legal Business Name): SIGURDUR EINARSSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 01/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 S PARK ST DEAN CLINIC
MADISON WI
53715-1830
US

IV. Provider business mailing address

700 S PARK ST DEAN CLINIC
MADISON WI
53715-1830
US

V. Phone/Fax

Practice location:
  • Phone: 608-260-2900
  • Fax: 608-260-2977
Mailing address:
  • Phone: 608-260-2900
  • Fax: 608-260-2977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number41541
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: