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Individual

BRENT ROBERT WEED

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3935 N. LIGHTNING DRIVE, APPLETON, WI 54913-7890
(920) 968-1790
(920) 686-9674
Mailing address
801 YORK ST, MANITOWOC, WI 54220-4630
(920) 663-9008
(920) 684-1439

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
47142
MN
207N00000X
Dermatology Physician
51390-020
WI
207ND0900X
Dermatopathology Physician
Primary
51390-020
WI
207ZD0900X
Dermatopathology (Pathology) Physician
51390-20
WI

Other

Enumeration date
12/30/2005
Last updated
08/02/2021
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