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Individual

DR. JONATHAN GEDYE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
430 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 929-9300
(920) 923-5260
Mailing address
430 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 929-9300
(920) 923-5260

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
31937-020
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
31770700
WI
Enumeration date
11/01/2006
Last updated
08/31/2010
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