Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
THALIA C NOEGROHO
Active Sole ProprietorTHALIA C NOEGROHO is a Physician Assistant healthcare provider located in MADISON, Wisconsin. NPI 1598229965 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · MADISON, WI
Registration Details
- NPI Number
- 1598229965
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jan 29, 2019 (7.5601843401674 yrs)
- Last Updated
- Sep 7, 2022
- License
-
5844-23 (WI)
- Sole Proprietor
- Yes
Practice Information
- Address
-
700 S PARK ST STE AMADISON, WI, 537151830Browse WI providers · Browse ZIP 53715
- Phone
- 6082602900
- Fax
- 6082602976
- Primary Specialty
-
Physician Assistant
363A00000X
- Additional Specialty
- Student (Health Education/Training)
- Additional Specialty
- Physician Assistant
Other Physician Assistant Providers in MADISON, WI
| Name | Credential | NPI |
|---|---|---|
| PAUL KENNETH GAVINS | PA-C | 1952308272 |
| CARRIE BACH | PA-C, MPAS | 1780679381 |
| DAWN M MCCOMB | PA-C | 1437145760 |
| MR. KEVIN T WYNE | PA-C | 1699757880 |
| BERNARD V KENNEDY | PA-C | 1629051446 |
| HOPE E REDDINGTON | P.A. | 1093792384 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.