Individual
LEILA R MIDELFORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
251 E COTTAGE GROVE RD, COTTAGE GROVE, WI 53527-9619
(608) 839-3515
Mailing address
251 E COTTAGE GROVE RD, COTTAGE GROVE, WI 53527-9619
(608) 839-3515
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
51140-020
WI
Other
Enumeration date
06/07/2006
Last updated
11/02/2020
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