Fasano, Robert A

Fasano, Robert A is an individual health care provider with primary practice located at N2950 State Road 67 , Lake Geneva WI 53147-2655. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is his primary health care specialty. Fasano, Robert A can be contacted via phone (262) 245-0535.

Contact Information

Primary practice address
N2950 State Road 67 Lake Geneva WI 53147-2655
Fax: (262) 245-2248
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 38693 Wisconsin
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036-102882 Illinois
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 38693-20 Wisconsin

Profile Details

NPI number 1770666471
LBN Legal business name Fasano, Robert A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 24th, 2006
Last updated Jan 12th, 2015 - about 9 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 1770666471 NPPES
Wisconsin Other FASANROB MERCYCARE INSURANCE
Wisconsin Other P00917285 MERCYCARE INSURANCE
Wisconsin MEDICAID 1770666471 MERCYCARE INSURANCE
Wisconsin MEDICAID 32332100 MERCYCARE INSURANCE

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