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General NPI Number Information
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NPI Number | 1508832684
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Entity Type | Individual
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Provider Name | GREGORY MEDIS MD
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Gender | Male
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Dates
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Enumeration Date | 02/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 600 HIGHLAND AVE
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City | MADISON
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State | WI
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Zip | 53792-0001
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Country | US
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Telephone | 606-265-1700
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Fax | 608-833-6932
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Provider Business Mailing Address
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Address Line | 8007 EXCELSIOR DR
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City | MADISON
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State | WI
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Zip | 53717-1962
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Country | US
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Telephone | 608-829-5201
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Fax | 608-833-6932
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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 | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 28844
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License Number State | WI
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