Doctor Name: | FREDRICK HOWARD BRONSON |
NPI Number: | 1710207923 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 14964 |
Business Practice Address: | 13 Cherokee Cir 102 Madison, WI - 537048480 |
Business Phone Number: | 6084676766 |
Business Fax Number: | |
Mailing Address: | 13 Cherokee Circle, 102 MADISON |
State: | WI |
Postal Code: | 537048481 |
Phone Number: | 6084676766 |
Fax Number: | |
NPI Enumeration Date: | 06/10/2010 |
NPI Last Update Date: | 06/10/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 14964 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |