Healthcare Provider Details

I. General information

NPI: 1902591175
Provider Name (Legal Business Name): YAGYA DHAKAL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2023
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3807 SPRING ST
MOUNT PLEASANT WI
53405-1667
US

IV. Provider business mailing address

3807 SPRING ST
MOUNT PLEASANT WI
53405-1667
US

V. Phone/Fax

Practice location:
  • Phone: 262-308-0447
  • Fax:
Mailing address:
  • Phone: 262-687-8328
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number86800
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: