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Individual
DR. JEFFREY C WIENKE JR.
Active
Individual
DR. JEFFREY C WIENKE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM CWSP
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
000820
IA
213E00000X
Podiatrist
206
SD
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
345
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
47-0836558
TAX ID
NE
Enumeration date
07/03/2009
Last updated
08/16/2017
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