Basic Information
| Provider Information | |||||||||
| NPI: | 1669815106 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CATAO | ||||||||
| FirstName: | FABIO | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| OtherLastName: | CATAO | ||||||||
| OtherFirstName: | FABIO | ||||||||
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| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 4005 COMMUNITY CENTER DRIVE | ||||||||
| Address2: | |||||||||
| City: | WAUSAU | ||||||||
| State: | WI | ||||||||
| PostalCode: | 544018246 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7152415400 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4005 COMMUNITY CENTER DR | ||||||||
| Address2: | |||||||||
| City: | WESTON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 544764139 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7152415400 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/15/2013 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 67048-20 | WI | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.