Individual
PETER WIRTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 HIGHLAND AVE, MADISON, WI 53792-0001
(608) 263-6400
Mailing address
600 HIGHLAND AVE, MADISON, WI 53792-0001
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
76721-20
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2020
Last updated
03/12/2022
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