Provider Demographics
NPI:1790913390
Name:NITSCHKE, RUPRECHT (MD)
Entity Type:Individual
Prefix:
First Name:RUPRECHT
Middle Name:
Last Name:NITSCHKE
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 1:7107 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-2712
Mailing Address - Country:US
Mailing Address - Phone:608-836-0099
Mailing Address - Fax:
Practice Address - Street 1:7107 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:MIDDLETON
Practice Address - State:WI
Practice Address - Zip Code:53562-2712
Practice Address - Country:US
Practice Address - Phone:608-836-0099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI47215-0202080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology