MEDICARE: MARK REICHELDERFER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	21068	WI

General Provider Information

NPI Number	:	1699736512
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK REICHELDERFER MD

Provider Business Mailing Address
First Line	:	513 OZARK TRL
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53705-2538
Country	:	US
Telephone Number	:	608-238-8235
Fax Number	:

Provider Business Practice Location Address
First Line	:	513 OZARK TRL
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53705-2538
Country	:	US
Telephone Number	:	608-238-8235
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/30/2006
Last Update Date	:	12/29/2025

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