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Individual

DR. KYLE MATTHEW WAISANEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
932 SPRING ST STE 101, PETOSKEY, MI 49770-2286
(231) 489-8298
(231) 489-8299
Mailing address
932 SPRING ST STE 101, PETOSKEY, MI 49770-2286
(231) 489-8298
(231) 489-8299

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
4301513351
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
118384100
FL
01
4301513351
MI LICENSE
MI
Enumeration date
04/09/2018
Last updated
10/11/2025
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