Individual
RENATO T FAYLONA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1310 BROADWAY RD, WISCONSIN DELLS, WI 53965-1358
(608) 253-1171
(608) 253-8012
Mailing address
PO BOX 840, WISCONSIN DELLS, WI 53965-0840
(608) 253-1171
(608) 253-8012
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
19822-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1006070
PHYSICIANS PLUS
WI
05
—
30997800
—
WI
01
—
3768
DEAN HEALTH INSURANCE
WI
Enumeration date
04/19/2006
Last updated
05/02/2008
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