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1366147639
ALEX PORTER TANNENBAUM
MADISON, WI
NPI
1366147639
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology
(Licence: WI 100344-851)
Enumeration Date
2023-04-04
Last Update Date
2023-06-16
Business Address
ALEX PORTER TANNENBAUM
749 UNIVERSITY ROW STE 200
MADISON, WI 53705-1465
Phone number: 608-263-6400
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Mailing Address
ALEX PORTER TANNENBAUM
600 HIGHLAND AVE
MADISON, WI 53792-0001
Phone number: 608-263-6400
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