Individual
PETER B IDSVOOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7102 MINERAL POINT RD, MADISON, WI 53717
(608) 828-7611
(608) 828-7656
Mailing address
202 S PARK ST, MADISON, WI 53715-1507
(608) 417-3886
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25300
WI
Other
Enumeration date
02/28/2006
Last updated
07/23/2019
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