Provider Demographics
NPI:1255794665
Name:SKENANDORE, DONALD WILLIAM JR (MD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:WILLIAM
Last Name:SKENANDORE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7633 GANSER WAY STE 204
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-2092
Mailing Address - Country:US
Mailing Address - Phone:608-829-1800
Mailing Address - Fax:
Practice Address - Street 1:7633 GANSER WAY STE 204
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-2092
Practice Address - Country:US
Practice Address - Phone:608-829-1800
Practice Address - Fax:608-829-1885
Is Sole Proprietor?:No
Enumeration Date:2016-04-02
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI684572084P0800X
WI68457-20208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice