Individual
MARK C MCDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
8700 W WATERTOWN PLANK RD, ORTHOPAEDIC SURGERY, MILWAUKEE, WI 53226
(414) 805-8602
(414) 805-7171
Mailing address
S68W15500 JANESVILLE RD, MUSKEGO, WI 53150-2613
(414) 422-4000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1305-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1861479479
—
WI
05
—
41923400
—
WI
Enumeration date
12/23/2005
Last updated
07/30/2018
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