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Contact Information

MELISSA FAUBERT, DO
160 VALLEY DR
LODI, WI53555-1464
 Phone: 608-592-3296
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine - Sports Medicine

207QS0010X 08 Physician/Family Practice
 

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for MELISSA FAUBERT · (Female)

NPI # 1194137026
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 05/27/2014
Last updated 09/06/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 036.143132
  • WI License # 69524-21
Hospital affiliation(s)
  • DIVINE SAVIOR HLTHCARE - (Acute Care)
    2817 NEW PINERY ROAD
    PORTAGE, WI 53901
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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