Provider Demographics
NPI:1972602381
Name:DINGES, CAROL M (MD)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:M
Last Name:DINGES
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:PO BOX 66
Mailing Address - Street 2:
Mailing Address - City:VIOLA
Mailing Address - State:WI
Mailing Address - Zip Code:54664-0066
Mailing Address - Country:US
Mailing Address - Phone:608-627-1407
Mailing Address - Fax:608-627-1405
Practice Address - Street 1:338 N. COMMERCIAL ST.
Practice Address - Street 2:
Practice Address - City:VIOLA
Practice Address - State:WI
Practice Address - Zip Code:54664-0066
Practice Address - Country:US
Practice Address - Phone:608-627-1407
Practice Address - Fax:607-627-1405
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI24343207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI30546900Medicaid
WI53072Medicare ID - Type Unspecified
WI30546900Medicaid