Mark W Niedfeldt, Md, LLC

NPI #1174764906 in Mequon, Wisconsin

Provider Information

NPI Number: 1174764906
Entity Type: Organization
Organization Name: Mark W Niedfeldt, Md, LLC
Primary Specialty: Family Medicine
Enumeration Date: Mar 6, 2009
Last Updated: Mar 6, 2009

Practice Location

Address: 10556 N PORT WASHINGTON RD
Address 2: STE 101
City: Mequon
State: Wisconsin
ZIP Code: 53092-5586
Phone: (262) 643-4720

Authorized Official

Name: DR. MARK W NIEDFELDT, M.D.
Title: OWNER
Phone: (262) 643-4720

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine - Sports Medicine — Sports Medicine	207QS0010X
Family Medicine	207Q00000X	Primary

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