Individual
WILLIAM P FAST
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
208 PARKER ST, BOSCOBEL, WI 53805-1648
(608) 375-4144
(608) 375-5629
Mailing address
208 PARKER ST, BOSCOBEL, WI 53805-1648
(608) 375-4144
(608) 375-5629
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21673
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30182900
—
WI
Enumeration date
03/07/2006
Last updated
07/09/2007
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