Individual
MARGARET I SCOTTBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2301 N LAKE DR RM 1577, COLUMBIA ST MARY'S MS CLINIC, MILWAUKEE, WI 53211-4508
(414) 291-1771
(414) 291-1781
Mailing address
4425 N PORT WASHINGTON RD, CLINIC CREDENTIALING, GLENDALE, WI 53212-1082
(414) 326-2218
(414) 326-2208
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2298
WI
363AS0400X
Surgical Physician Assistant
2298-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2298-23
STATE LICENSE
WI
Enumeration date
07/08/2008
Last updated
05/02/2014
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