Healthcare Provider Details

I. General information

NPI: 1003039678
Provider Name (Legal Business Name): LYNN E DOLAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LYNN E SCHMIDT-DOLAN MD

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 03/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13950 W CAPITOL DRIVE
BROOKFIELD WI
53005-2441
US

IV. Provider business mailing address

BOX 860001
MINNEAPOLIS MN
55486-6000
US

V. Phone/Fax

Practice location:
  • Phone: 615-778-4066
  • Fax: 414-302-5404
Mailing address:
  • Phone: 877-304-6332
  • Fax: 615-778-9114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberWI 40319
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number40319
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: