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Individual
MARK LEDESMA
Active
Individual
MARK LEDESMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
57355
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/26/2010
Last updated
03/11/2013
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