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Individual

PAUL G WENNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
901 MONTGOMERY STREET, WINNESHIEK MEDICAL CENTER, DECORAH, IA 52101-2325
(563) 382-2911
(563) 387-3102
Mailing address
901 MONTGOMERY STREET, DECORAH, IA 52101-2325
(563) 382-2911
(563) 387-3102

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
3130-850
WI
207Q00000X
Family Medicine Physician
Primary
39396
IA
207Q00000X
Family Medicine Physician
55507
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1023248614
IA
05
1032348614
MN
Enumeration date
07/17/2009
Last updated
01/22/2015
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