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Individual

KENNETH C WEIMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1025 MARSH ST, MANKATO, MN 56001-4752
(507) 625-4031
Mailing address
1025 MARSH ST, MANKATO, MN 56001-4752
(507) 625-4031

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
43671
WI
208000000X
Pediatrics Physician
52805
AZ
208000000X
Pediatrics Physician
Primary
56450
MN
2080A0000X
Pediatric Adolescent Medicine Physician
56450
MN

Other

Enumeration date
09/26/2006
Last updated
09/18/2020
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