Individual
MOLLIE A CHARON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
530 WI DELLS PARKWAY SOUTH, LAKE DELTON, WI 53940
(608) 254-5400
(608) 253-8585
Mailing address
530 WI DELLS PARKWAY SOUTH, LAKE DELTON, WI 53940
(608) 254-5400
(608) 253-8585
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
64472-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013159508
—
WI
01
—
P01558256
RAILROAD MEDICARE
WI
Enumeration date
03/30/2009
Last updated
12/22/2021
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