Tara L. Passow MD INC

NPI #1992998884 in Beaver Dam, Wisconsin

Provider Information

NPI Number: 1992998884
Entity Type: Organization
Organization Name: Tara L. Passow MD INC
Primary Specialty: Specialist
Enumeration Date: Aug 23, 2007
Last Updated: Mar 26, 2009

Practice Location

Address: 700 HILLCREST CT
City: Beaver Dam
State: Wisconsin
ZIP Code: 53916-2418
Phone: (920) 885-2622

Authorized Official

Name: TARA L PASSOW, M.D.
Title: PRESIDENT
Phone: (920) 885-2622

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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