Healthcare Provider Details

I. General information

NPI: 1194012179
Provider Name (Legal Business Name): DOUGLAS RANDAL ZABROWSKI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2011
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2575 E EVERGREEN DR
APPLETON WI
54913-8910
US

IV. Provider business mailing address

2575 E EVERGREEN DR
APPLETON WI
54913-8910
US

V. Phone/Fax

Practice location:
  • Phone: 920-969-5353
  • Fax: 414-337-7201
Mailing address:
  • Phone: 920-969-5353
  • Fax: 414-337-7201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number67448
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: