Individual
DR. PETER MICHAEL MEDVED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9200 W LOOMIS RD, FRANKLIN, WI 53132-8887
(414) 529-9330
(414) 529-9331
Mailing address
9200 W LOOMIS RD, FRANKLIN, WI 53132-8887
(414) 529-9330
(414) 529-9331
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
24579
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24579
STATE LICENSE #
WI
05
—
30756000
—
WI
Enumeration date
07/27/2006
Last updated
03/07/2023
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