Individual ProviderMark C McdonaldPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address8700 W Watertown Plank Rd, Orthopaedic Surgery, Milwaukee, WI 53226(414) 805-8602(414) 422-4000PECOS EnrollmentBased on the most recent information from CMS, provider Mark C Mcdonald 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 ID1861479479Provider TypeIndividualFull NameMcdonald, Mark CCredentialP.A.GenderMaleSole ProprietorNoEnumeration Date12/23/2005Last Updated7/30/2018Contact InformationPractice LocationPractice Address8700 W Watertown Plank Rd, Orthopaedic Surgery, Milwaukee, WI 53226Phone(414) 805-8602Fax(414) 805-7171Mailing LocationMailing AddressS68w15500 Janesville Rd, Muskego, WI 53150-2613Phone(414) 422-4000FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363A00000XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicense1305-023WisconsinProvider IdentifiersIDDescriptionIssuerID41923400DescriptionMedicaidIssuerUnlistedWisconsinID1861479479DescriptionMedicaidIssuerUnlistedWisconsin