# KEVIN FERREIRA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205157138
- **Authorized official:** KEVIN JUAN FERREIRA MD (OWNER)
- **Authorized official phone:** (715) 451-6065

## Contact information

- **Practice address:** 410 DEWEY ST, WISCONSIN RAPIDS, WI 54494-4715
- **Practice address phone:** (715) 423-6060
- **Mailing address:** 5030 PRAIRIE VIEW DR, WISCONSIN RAPIDS, WI 54494-2752

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 49425 | WI | Yes |

## Other

- **Enumeration date:** 06/15/2010
- **Last updated:** 06/15/2010