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Organization

MARY MCDONALD MD SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
HEATHER LENZ (OFFICE MANAGER)
(920) 426-2211
Entity
Organization

Contact information

Practice address
2700 W 9TH AVE, SUITE 300, OSHKOSH, WI 54904-7247
(920) 223-0490
Mailing address
3420 JACKSON ST, SUITE E, OSHKOSH, WI 54901-8144
(920) 426-2211
(920) 426-2231

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
28027020
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
21299800
WI
Enumeration date
07/28/2006
Last updated
10/10/2017
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