MEDICARE: MARCY L MCADOO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	29736	WI

General Provider Information

NPI Number	:	1164434023
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCY L MCADOO M.D.

Provider Business Mailing Address
First Line	:	17000 W NORTH AVE STE 200E
Second Line	:
City	:	BROOKFIELD
State	:	WI
Zip	:	53005-4425
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	17000 W NORTH AVE STE 200E
Second Line	:
City	:	BROOKFIELD
State	:	WI
Zip	:	53005-4425
Country	:	US
Telephone Number	:	262-594-2946
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2006
Last Update Date	:	06/21/2019

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