Provider Demographics
NPI:1245206317
Name:EINARSSON, SIGURDUR (MD)
Entity Type:Individual
Prefix:
First Name:SIGURDUR
Middle Name:
Last Name:EINARSSON
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 1:700 S PARK ST
Mailing Address - Street 2:DEAN CLINIC
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53715-1830
Mailing Address - Country:US
Mailing Address - Phone:608-260-2900
Mailing Address - Fax:608-260-2977
Practice Address - Street 1:700 S PARK ST
Practice Address - Street 2:DEAN CLINIC
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53715-1830
Practice Address - Country:US
Practice Address - Phone:608-260-2900
Practice Address - Fax:608-260-2977
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI41541207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI61069OtherDEAN HEALTH INSURANCE
WI741501791Medicare PIN