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NPI Code Detail

MEDICARE: DR. BRIAN VAN LE M.D.

MEDICARE:  DR. BRIAN VAN LE  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208800000XUrology Physician125053504IL
2208800000XUrology Physician62203WI

General Provider Information

NPI Number : 1063668119
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRIAN VAN LE M.D.
Provider Business Mailing Address
First Line : 5001 LAKE MENDOTA DR
Second Line :
City : MADISON
State : WI
Zip : 53705-1307
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5001 LAKE MENDOTA DR
Second Line :
City : MADISON
State : WI
Zip : 53705-1307
Country : US
Telephone Number : 703-477-5514
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2008
Last Update Date : 08/26/2022

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Directions to “ DR. BRIAN VAN LE M.D.” Practice Location

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