Provider Demographics
NPI:1457315160
Name:FRONDA, GERARDO P (MD)
Entity Type:Individual
Prefix:DR
First Name:GERARDO
Middle Name:P
Last Name:FRONDA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:W180N8085 TOWN HALL RD
Mailing Address - Street 2:DEPT OF PATHOLOGY
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-3518
Mailing Address - Country:US
Mailing Address - Phone:262-257-3254
Mailing Address - Fax:262-257-5545
Practice Address - Street 1:W180N8085 TOWN HALL RD
Practice Address - Street 2:DEPT OF PATHOLOGY
Practice Address - City:MENOMONEE FALLS
Practice Address - State:WI
Practice Address - Zip Code:53051-3518
Practice Address - Country:US
Practice Address - Phone:262-257-3254
Practice Address - Fax:262-257-5545
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036-082351207ZP0105X
WI48810207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1457315160Medicaid
IL036-082351-1Medicaid
WI1457315160Medicaid
ILF31164Medicare UPIN
WI34817500Medicaid