# DOENIER FAMILY MEDICINE SC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508046517
- **Authorized official:** TODD M DOENIER MD (PHYSICIAN)
- **Authorized official phone:** (262) 446-0955

## Contact information

- **Practice address:** 1111 DELAFIELD ST STE 300, WAUKESHA, WI 53188-3407
- **Practice address phone:** (262) 446-0955
- **Practice address fax:** (262) 446-0055
- **Mailing address:** 1111 DELAFIELD ST STE 300, WAUKESHA, WI 53188-3407
- **Mailing address phone:** (262) 446-0955
- **Mailing address fax:** (262) 446-0055

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 33378 | WI | Yes |

## Other

- **Enumeration date:** 11/07/2007
- **Last updated:** 11/29/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1508046517 | — | WI |