Healthcare Provider Details

I. General information

NPI: 1790104321
Provider Name (Legal Business Name): GRETCHEN MARIE FRY DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GRETCHEN M ADAMS DO

II. Dates (important events)

Enumeration Date: 04/10/2014
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

752 N HIGH POINT RD
MADISON WI
53717-2236
US

IV. Provider business mailing address

752 N HIGH POINT RD
MADISON WI
53717-2236
US

V. Phone/Fax

Practice location:
  • Phone: 608-824-4000
  • Fax: 608-824-4104
Mailing address:
  • Phone: 608-824-4000
  • Fax: 608-824-4917

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number64495-21
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number64495-21
License Number StateWI
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number64495-21
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: