Healthcare Provider Details

I. General information

NPI: 1891927687
Provider Name (Legal Business Name): ELISAVET PAPLOMATA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2009
Last Update Date: 10/28/2021
Certification Date: 10/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 MANITOU WAY
MADISON WI
53711-3014
US

IV. Provider business mailing address

4150 MANITOU WAY
MADISON WI
53711-3014
US

V. Phone/Fax

Practice location:
  • Phone: 404-654-7828
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number69920
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number72136
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number72136
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: