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NPI Code Detail

MEDICARE: SYDNEY STERLING TARDREW PA-C

MEDICARE: SYDNEY STERLING TARDREW PA-C
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
1363AM0700XMedical Physician Assistant7373-23WI

General Provider Information

NPI Number : 1902424054
Entity Type Code : Individual
Provider Name (Legal Business Name) : SYDNEY STERLING TARDREW PA-C
Provider Business Mailing Address
First Line : 7974 UW HEALTH CT
Second Line :
City : MIDDLETON
State : WI
Zip : 53562-5531
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 600 HIGHLAND AVE
Second Line :
City : MADISON
State : WI
Zip : 53792-5705
Country : US
Telephone Number : 608-263-5442
Fax Number : 608-265-1753
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2020
Last Update Date : 12/05/2023

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