NPI 1003445545

Mariana Lee Montero Jaques, MD

Practitioner Pediatrics Physician Madison, WI

Practice location

Address: 2402 Winnebago St, Madison, WI 53704-5341
Phone: (608) 242-6855
Mailing address: 7974 Uw Health CT, Middleton, WI 53562-5531

Registered specialties (2)

Pediatrics Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208000000X Licence 77648-20 (WI)

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Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

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Registry record

NPI: 1003445545
Entity type: Individual
Sex (as registered): Female
NPI issued: 6 Apr 2020
Record last updated: 4 Aug 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.