Provider Demographics
NPI:1386349199
Name:MCDONALD, COLE JAMES
Entity type:Individual
Prefix:
First Name:COLE
Middle Name:JAMES
Last Name:MCDONALD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N55W17923 HIGH BLUFF DR UNIT F
Mailing Address - Street 2:
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-1495
Mailing Address - Country:US
Mailing Address - Phone:608-482-4386
Mailing Address - Fax:
Practice Address - Street 1:N55W17923 HIGH BLUFF DR UNIT F
Practice Address - Street 2:
Practice Address - City:MENOMONEE FALLS
Practice Address - State:WI
Practice Address - Zip Code:53051-1495
Practice Address - Country:US
Practice Address - Phone:608-482-4386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-03
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program