Individual
DR. BRADLEY M FIDELER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
N2950 STATE ROAD 67, LAKE GENEVA, WI 53147-2655
(262) 245-0535
Mailing address
N2950 STATE ROAD 67, LAKE GENEVA, WI 53147-2655
(262) 245-0535
Taxonomy
Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
36125
WI
207XS0106X
Orthopaedic Hand Surgery Physician
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32141800
—
WI
Enumeration date
10/26/2006
Last updated
07/08/2007
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