Provider Demographics
NPI:1043267172
Name:RANUM, WILLIAM H (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:H
Last Name:RANUM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 S CENTURY AVE
Mailing Address - Street 2:
Mailing Address - City:WAUNAKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53597-2386
Mailing Address - Country:US
Mailing Address - Phone:608-849-4315
Mailing Address - Fax:608-850-1606
Practice Address - Street 1:1300 S CENTURY AVE
Practice Address - Street 2:
Practice Address - City:WAUNAKEE
Practice Address - State:WI
Practice Address - Zip Code:53597-2386
Practice Address - Country:US
Practice Address - Phone:608-849-4315
Practice Address - Fax:608-850-1606
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI29827-020207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1043267172Medicaid
WI31587100Medicaid
E46203Medicare UPIN
WI2127OtherDEAN HEALTH INSURANCE
WI024074150Medicare PIN