Provider Demographics
NPI:1619933488
Name:ZARWELL, TODD M (OD)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:M
Last Name:ZARWELL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 REGENT ST
Mailing Address - Street 2:DAVIS DUEHR DEAN/DEAN MEDICAL CENTER
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53715-1248
Mailing Address - Country:US
Mailing Address - Phone:608-282-2000
Mailing Address - Fax:608-282-2172
Practice Address - Street 1:1025 REGENT ST
Practice Address - Street 2:DAVIS DUEHR DEAN/DEAN MEDICAL CENTER
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53715-1248
Practice Address - Country:US
Practice Address - Phone:608-282-2000
Practice Address - Fax:608-282-2172
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2756-035152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI7053OtherDEAN HEALTH INSURANCE
WI38606300Medicaid
WI38606300Medicaid
WI7053OtherDEAN HEALTH INSURANCE
WI000354340Medicare PIN
WI063474150Medicare PIN