Basic Information
Provider Information
NPI: 1780648337
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BECKMAN
FirstName: CATHERINE
MiddleName: W
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: WELLING
OtherFirstName: CATHERINE
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 7974 UW HEALTH CT
Address2:  
City: MIDDLETON
State: WI
PostalCode: 535625531
CountryCode: US
TelephoneNumber: 6088295485
FaxNumber:  
Practice Location
Address1: 1 S PARK ST
Address2:  
City: MADISON
State: WI
PostalCode: 53715
CountryCode: US
TelephoneNumber: 6082872100
FaxNumber: 6082872324
Other Information
ProviderEnumerationDate: 04/12/2006
LastUpdateDate: 01/26/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000X31863WIY Allopathic & Osteopathic PhysiciansSurgery 

No ID Information.


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