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1154305761
MARK OTTO WEISSE
MADISON, WI
NPI
1154305761
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: WI 20893)
Enumeration Date
2005-12-06
Last Update Date
2007-07-08
Business Address
-- MARK OTTO WEISSE MD
115 W DOTY ST PHS MEDICAL OFFICE
MADISON, WI 53703-3276
Phone number: 608-284-6071
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Mailing Address
-- MARK OTTO WEISSE MD
5391 MARINERS COVE DR UNIT 202
MADISON, WI 53704-7615
Phone number: 608-241-5429
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