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Individual
DR. MARY LISA LANDWEHR
Active
Individual
DR. MARY LISA LANDWEHR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
45925
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-14760
MEDICA
WI
01
—
2135289
FIRST HEALTH
WI
01
—
34433500
WISCONSIN RISK
WI
05
—
34433500
—
WI
01
—
370T4LA
ATRIUM SENIOR PLAN
WI
01
—
391435797
EMPLOYERS HEALTH
WI
01
—
864421040063
PREFERRED ONE
WI
01
—
87843
GREATER MARSHFIELD PLAN
WI
01
—
H77162
GROUP HEALTH
WI
01
—
P00058497
TRAVELERS RAILROAD
WI
01
—
W005284
CHAMPUS
WI
Enumeration date
05/24/2005
Last updated
05/06/2011
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