Healthcare Provider Details

I. General information

NPI: 1669635868
Provider Name (Legal Business Name): MARGARET I SCOTTBERG PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARGARET I GILGENBACH PA

II. Dates (important events)

Enumeration Date: 07/08/2008
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

N143W6515 PIONEER RD
CEDARBURG WI
53012-2705
US

IV. Provider business mailing address

N143W6515 PIONEER RD
CEDARBURG WI
53012-2705
US

V. Phone/Fax

Practice location:
  • Phone: 262-377-6933
  • Fax:
Mailing address:
  • Phone: 262-377-6933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number2298-23
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number2298
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: