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Individual

MARK E. NORDNESS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
240 MAPLE AVENUE, PROHEALTH CARE MEDICAL ASSOCIATES INC., MUKWONAGO, WI 53149
(262) 928-1900
(262) 363-1949
Mailing address
N17 W24100 RIVERWOOD DRIVE SUITE 250, PROHEALTH CARE MEDICAL ASSOCIATES INC., WAUKESHA, WI 53149
(262) 928-4100
(262) 928-5835

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
41406
WI
208000000X
Pediatrics Physician
41406-020
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
34064800
WI
Enumeration date
02/09/2006
Last updated
11/23/2011
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