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Individual
KEITH THOMAS WENDA
Active
Individual
KEITH THOMAS WENDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
34988
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
769063100
—
MN
Enumeration date
03/24/2006
Last updated
10/10/2011
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