Individual
ROBERT LIEDTKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
N82W23422 FIVE IRON WAY, SUSSEX, WI 53089-1556
(414) 335-6921
Mailing address
N82W23422 FIVE IRON WAY, SUSSEX, WI 53089-1556
(414) 335-6921
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
38057
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32431700
—
WI
Enumeration date
02/13/2006
Last updated
06/01/2023
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