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General NPI Number Information
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NPI Number | 1336125939
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Entity Type | Individual
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Provider Name | WENDY L MOLASKA MD
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Gender | Female
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Dates
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Enumeration Date | 12/16/2005
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Last Update Date | 01/18/2022
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Provider Practice Location Address
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Address Line | 2990 TRIVERTON PIKE DR # 101
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City | FITCHBURG
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State | WI
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Zip | 53711-5904
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Country | US
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Telephone | 608-305-4515
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Fax | 608-721-6006
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Provider Business Mailing Address
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Address Line | 3034 BOSSHARD DR
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City | FITCHBURG
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State | WI
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Zip | 53711-5858
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Country | US
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Telephone | 612-770-8695
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 42881
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 51915-20
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License Number State | WI
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