Healthcare Provider Details

I. General information

NPI: 1235169251
Provider Name (Legal Business Name): MARK T. CATHERALL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1004 N 10TH ST
MILWAUKEE WI
53233-1423
US

IV. Provider business mailing address

220 W CAPITOL DR
GLENDALE WI
53212-1185
US

V. Phone/Fax

Practice location:
  • Phone: 414-727-6320
  • Fax:
Mailing address:
  • Phone: 414-727-6320
  • Fax: 414-727-6328

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number47836
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number47836
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: