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Mark Lydecker
NPI 1669010963 · on the registry since 2019
Practice
- Address
- 8700 W Watertown Plank Rd
Wauwatosa, WI 53226 - Phone
- (414) 805-8656
- Clinicians at this address
- 9
Registry record
- Primary taxonomy
- 225100000X
225100000X
- Also registered as
- 2255A2300X
- Licence states on file
- WI
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2019-12-17
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wisconsin