Provider Demographics
NPI:1790056984
Name:DEANO, RODERICK (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:RODERICK
Middle Name:
Last Name:DEANO
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:DR
Other - First Name:ROD
Other - Middle Name:
Other - Last Name:DEANO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:7974 UW HEALTH CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-5531
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:600 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53792-0001
Practice Address - Country:US
Practice Address - Phone:608-263-1530
Practice Address - Fax:608-265-8887
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-19
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILC6873/AU3890402207R00000X
WI64177-20207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine