Individual
JOEL WEGENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2615 EAST FRANKLIN AVENUE, UFP-SMILEY'S CLINIC, MINNEAPOLIS, MN 55406
(612) 333-0770
(612) 333-0475
Mailing address
420 DELAWARE STREET SE, MMC 292, UNIVERSITY OF MINNESOTA PHYSICIANS, MINNEAPOLIS, MN 55455
(612) 333-0475
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
45155
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-18359
MEDICA - CHOICE
MN
05
—
0595637
—
IA
01
—
1032282
PREFERREDONE
MN
01
—
132038
UCARE
MN
01
—
1725613
ARAZ
MN
05
—
443917100
—
MN
01
—
548R7WE
BCBS
MN
01
—
HP40859
HEALTHPARTNERS
MN
Enumeration date
09/20/2006
Last updated
04/11/2012
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