Individual
MARK A FUSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
575 4TH ST, KEWAUNEE, WI 54216-1785
(920) 388-4640
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7222
(920) 445-7229
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
374-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42910400
—
WI
Enumeration date
09/20/2005
Last updated
07/22/2015
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