Provider Demographics
NPI:1609986850
Name:WALDMAN, ARTHUR (MD)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:
Last Name:WALDMAN
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 1:1003 ROOSTER RUN
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-3872
Mailing Address - Country:US
Mailing Address - Phone:608-203-5085
Mailing Address - Fax:
Practice Address - Street 1:1003 ROOSTER RUN
Practice Address - Street 2:
Practice Address - City:MIDDLETON
Practice Address - State:WI
Practice Address - Zip Code:53562-3872
Practice Address - Country:US
Practice Address - Phone:608-203-5085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2013-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI20778207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI30135300Medicaid
WI30135300Medicaid
B57424Medicare UPIN