Provider Demographics
NPI:1639174782
Name:EGGERT, CARI A (MD)
Entity Type:Individual
Prefix:
First Name:CARI
Middle Name:A
Last Name:EGGERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 KNUTSON DR
Mailing Address - Street 2:CENTRAL WISCONSIN CENTER
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-1133
Mailing Address - Country:US
Mailing Address - Phone:608-301-9227
Mailing Address - Fax:608-223-7727
Practice Address - Street 1:317 KNUTSON DR
Practice Address - Street 2:CENTRAL WISCONSIN CENTER
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-1133
Practice Address - Country:US
Practice Address - Phone:608-301-9227
Practice Address - Fax:608-223-7727
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI47229208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI34396800Medicaid
WI34396800Medicaid
WI0835Medicare PIN