Individual
DR. MARK WILLIAM WIRTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 N NINE MOUND RD, VERONA, WI 53593-1032
(608) 845-9531
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
71092-20
WI
207Q00000X
Family Medicine Physician
MD-41706
IA
Other
Enumeration date
05/22/2012
Last updated
01/19/2021
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