Individual
MARK F FENLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2401 PLOVER ROAD, PLOVER, WI 54467
(715) 259-3800
Mailing address
900 ILLINOIS AVENUE, STEVENS POINT, WI 54481
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
26785
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30689500
—
WI
Enumeration date
12/15/2006
Last updated
05/23/2008
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