Charon, Mollie A

Charon, Mollie A is an individual health care provider with primary practice located at 530 Wi Dells Parkway South , Lake Delton WI 53940. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Charon, Mollie A can be contacted via phone (608) 254-5400.

Contact Information

Primary practice address
530 Wi Dells Parkway South Lake Delton WI 53940
Phone: (608) 254-5400
Fax: (608) 253-8585
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 64472-20 Wisconsin

Profile Details

NPI number 1013159508
LBN Legal business name Charon, Mollie A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 30th, 2009
Last updated Dec 22nd, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013159508 NPPES
Wisconsin Other P01558256 RAILROAD MEDICARE
Wisconsin MEDICAID 1013159508 RAILROAD MEDICARE

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