Individual ProviderRyan S FellPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address2323 N Mayfair Rd, Suite 310, Milwaukee, WI 53226-1506(414) 384-6700PECOS EnrollmentBased on the most recent information from CMS, provider Ryan S Fell does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1376950881Provider TypeIndividualFull NameFell, Ryan SCredentialP.A.GenderMaleSole ProprietorNoEnumeration Date7/16/2014Last Updated8/20/2014Contact InformationPractice LocationPractice Address2323 N Mayfair Rd, Suite 310, Milwaukee, WI 53226-1506Phone(414) 384-6700Fax(414) 727-1058Mailing LocationMailing Address2323 N Mayfair Rd, Suite 300, Milwaukee, WI 53226-1506Phone(414) 384-6700Fax(414) 727-1058Provider TaxonomiesCodeDescriptionLicenseCode363A00000XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicense3368-23WisconsinProvider IdentifiersIDDescriptionIssuerID1376950881DescriptionMedicaidIssuerUnlistedWisconsin