Provider Demographics
NPI:1922322619
Name:SHERYL SPITZER -RESNICK MD, LLC
Entity Type:Organization
Organization Name:SHERYL SPITZER -RESNICK MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERYL
Authorized Official - Middle Name:K
Authorized Official - Last Name:SPITZER -RESNICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:608-221-1501
Mailing Address - Street 1:4901 COTTAGE GROVE ROAD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53716
Mailing Address - Country:US
Mailing Address - Phone:608-221-1501
Mailing Address - Fax:608-223-3540
Practice Address - Street 1:251 EAST COTTAGE GROVE ROAD
Practice Address - Street 2:
Practice Address - City:COTTAGE GROVE
Practice Address - State:WI
Practice Address - Zip Code:53527
Practice Address - Country:US
Practice Address - Phone:608-839-3515
Practice Address - Fax:608-839-3541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-24
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty