Basic Information
Provider Information
NPI: 1497070601
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FERGUSON
FirstName: SANCIA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7974 UW HEALTH CT
Address2:  
City: MIDDLETON
State: WI
PostalCode: 535625531
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 345 W WASHINGTON AVE
Address2:  
City: MADISON
State: WI
PostalCode: 537032996
CountryCode: US
TelephoneNumber: 6084178300
FaxNumber: 6084178301
Other Information
ProviderEnumerationDate: 03/30/2010
LastUpdateDate: 01/25/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/25/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RR0500X72518WIY Allopathic & Osteopathic PhysiciansInternal MedicineRheumatology

No ID Information.


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