Individual
DR. MICHELLE ELAINE MARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
752 N HIGH POINT RD, MADISON, WI 53717-2236
(608) 824-4000
(608) 824-4956
Mailing address
151 E WILSON ST APT 1207, MADISON, WI 53703-4645
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
83220-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457912123
—
WI
Enumeration date
06/24/2019
Last updated
09/13/2024
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