Individual
MARK LEDESMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2801 W KINNICKINNIC RIVER PKWY, SUITE 250, MILWAUKEE, WI 53215-3669
(414) 649-6732
(414) 649-5840
Mailing address
2801 W KINNICKINNIC RIVER PKWY, SUITE 250, MILWAUKEE, WI 53215-3669
(414) 649-6732
(414) 649-5840
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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