Organization
THOMAS G. FENSKE M.D., S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS G FENSKE M.D. (PRESIDENT)
(414) 385-2499
Entity
Organization
Contact information
Practice address
2801 W KINNICKINNIC RIVER PKWY, SUITE 925, MILWAUKEE, WI 53215-3669
(414) 385-2499
(414) 385-2748
Mailing address
2801 W KINNICKINNIC RIVER PKWY, SUITE 925, MILWAUKEE, WI 53215-3669
(414) 385-2499
(414) 385-2748
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
3459-033
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32279000
—
WI
Enumeration date
04/23/2008
Last updated
04/23/2008
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