Individual
RANDY S HEIDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
20 S PARK ST, MADISON, WI 53715-1348
(608) 287-2250
(608) 287-2438
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
36553-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003855206
—
WI
Enumeration date
06/05/2006
Last updated
12/29/2021
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