Basic Information
| Provider Information | |||||||||
| NPI: | 1922322619 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SHERYL SPITZER -RESNICK MD, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4901 COTTAGE GROVE ROAD | ||||||||
| Address2: | |||||||||
| City: | MADISON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 53716 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6082211501 | ||||||||
| FaxNumber: | 6082233540 | ||||||||
| Practice Location | |||||||||
| Address1: | 251 EAST COTTAGE GROVE ROAD | ||||||||
| Address2: | |||||||||
| City: | COTTAGE GROVE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 53527 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6088393515 | ||||||||
| FaxNumber: | 6088393541 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/24/2010 | ||||||||
| LastUpdateDate: | 03/24/2010 | ||||||||
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| AuthorizedOfficialLastName: | SPITZER -RESNICK | ||||||||
| AuthorizedOfficialFirstName: | SHERYL | ||||||||
| AuthorizedOfficialMiddleName: | K | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT/OWNER | ||||||||
| AuthorizedOfficialTelephone: | 6082211501 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.