Individual
KARL PENNAU
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
421 CAMELOT DR, FOND DU LAC, WI 54935-4560
(920) 926-8616
Mailing address
420 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-8340
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
24240
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13880
DEAN
WI
05
—
30286500
—
WI
01
—
P00224646
RAILROAD MEDICARE
WI
01
—
WI01S7
JOHN DEERE
WI
Enumeration date
11/15/2005
Last updated
07/08/2007
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