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General NPI Number Information
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NPI Number | 1194104828
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Entity Type | Individual
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Provider Name | HANNAH WAKEFIELD M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/27/2015
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Last Update Date | 11/07/2024
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Provider Practice Location Address
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Address Line | 5249 E TERRACE DR
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City | MADISON
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State | WI
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Zip | 53718-8339
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Country | US
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Telephone | 608-265-1212
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Fax |
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Provider Business Mailing Address
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Address Line | 7974 UW HEALTH CT
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City | MIDDLETON
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State | WI
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Zip | 53562-5531
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MMD.38239.LL
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 102319-875
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License Number State | WI
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