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Individual

DEBRA K MARKWARDT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
425 PINE RIDGE BLVD, SUITE 211, WAUSAU, WI 54401-4123
(715) 845-5505
(715) 848-2884
Mailing address
425 PINE RIDGE BLVD, SUITE 211, WAUSAU, WI 54401-4123
(715) 845-5505
(715) 848-2884

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
2839820
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
25487
SECURITY HEALTH MEDICAID
WI
01
31611800
MANAGED HEALTH CARE
WI
05
31611800
WI
01
MARKWARDT
WPS
WI
Enumeration date
07/24/2006
Last updated
07/09/2007
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