Fideler, Bradley M

Fideler, Bradley M is an individual health care provider with primary practice located at N2950 State Road 67 , Lake Geneva WI 53147-2655. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hand Surgery, which is considered as his primary health care specialty. Fideler, Bradley M can be contacted via phone (262) 245-0535.

Contact Information

Primary practice address
N2950 State Road 67 Lake Geneva WI 53147-2655
Phone: (262) 245-0535
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hand Surgery 207XS0106X 36125 Wisconsin
Allopathic & Osteopathic Physicians / Hand Surgery 207XS0106X Illinois

Profile Details

NPI number 1629153077
LBN Legal business name Fideler, Bradley M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 26th, 2006
Last updated Jul 8th, 2007 - about 17 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 1629153077 NPPES
Wisconsin MEDICAID 32141800

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