Individual
MICHELLE C PESEK-MCCOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
430 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-4600
Mailing address
420 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-8343
(920) 926-8370
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
47967-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34664800
—
WI
01
—
P00271980
MEDICARE RAILROAD
WI
Enumeration date
06/25/2006
Last updated
12/07/2020
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