Individual
SCOTT D. FENSKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14555 W NATIONAL AVE, SUITE 170, NEW BERLIN, WI 53151-4494
(262) 827-3636
(262) 827-3626
Mailing address
3003 W GOOD HOPE RD, MILWAUKEE, WI 53209-2042
(414) 352-3100
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
26964
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30808000
—
WI
01
—
P00627750
RR MEDICARE
WI
Enumeration date
08/26/2005
Last updated
12/01/2021
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