Individual
MARLISE K. DAVIDSON-FIEDLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1000 MINERAL POINT AVE, JANESVILLE, WI 53548
(608) 756-6611
(608) 756-6177
Mailing address
1000 MINERAL POINT AVE, JANESVILLE, WI 53548-2940
(608) 756-6611
(608) 756-6177
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
67824-20
WI
207Q00000X
Family Medicine Physician
T9834
TX
208M00000X
Hospitalist Physician
67824-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1157
MERCYCARE INSURANCE
WI
01
—
1528590908
BCBSWI
WI
05
—
1528590908
—
WI
01
—
K400429384
WI MEDICARE
WI
Enumeration date
04/03/2017
Last updated
09/25/2023
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