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Individual
KEVIN SPONSELLER
Active
Individual
KEVIN SPONSELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
146D00000X
Personal Emergency Response Attendant
—
—
207Q00000X
Family Medicine Physician
Primary
39188
SC
207Q00000X
Family Medicine Physician
62618-20
WI
390200000X
Student in an Organized Health Care Education/Training Program
62618-20
WI
Other
Enumeration date
07/25/2014
Last updated
08/23/2023
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