Provider Demographics
NPI:1295879682
Name:PADBERG, SUSAN E (MD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:E
Last Name:PADBERG
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 1:1025 FRIAR LN
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53711-2509
Mailing Address - Country:US
Mailing Address - Phone:608-276-7859
Mailing Address - Fax:608-276-7669
Practice Address - Street 1:3801 REGENT ST
Practice Address - Street 2:SUITE 1B
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-5202
Practice Address - Country:US
Practice Address - Phone:608-204-7410
Practice Address - Fax:608-276-7669
Is Sole Proprietor?:No
Enumeration Date:2007-02-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI29287-020207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine