Individual
MARK A LEIBEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 HIGHLAND AVE, B6/319 CSC, MADISON, WI 53792-3272
(608) 263-8100
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
Taxonomy
Speciality
Code
Description
License number
State
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
Primary
44836
WI
207Q00000X
Family Medicine Physician
44836
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080190901
RAILROAD MEDICARE
WI
01
—
13311
DEAN
WI
05
—
34251400
—
WI
01
—
390807236A3
UNITY
WI
01
—
44836
TOUCHPOINT
WI
01
—
WI01N2
JOHN DEERE
WI
Enumeration date
11/14/2005
Last updated
07/16/2013
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