Healthcare Provider Details

I. General information

NPI: 1922322619
Provider Name (Legal Business Name): SHERYL SPITZER -RESNICK MD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2010
Last Update Date: 03/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 EAST COTTAGE GROVE ROAD
COTTAGE GROVE WI
53527
US

IV. Provider business mailing address

4901 COTTAGE GROVE ROAD
MADISON WI
53716
US

V. Phone/Fax

Practice location:
  • Phone: 608-839-3515
  • Fax: 608-839-3541
Mailing address:
  • Phone: 608-221-1501
  • Fax: 608-223-3540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SHERYL K SPITZER -RESNICK
Title or Position: PRESIDENT/OWNER
Credential: MD
Phone: 608-221-1501