Individual
KENNETH BUETTNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
28512 69TH PL, SALEM, WI 53168-9168
(262) 960-5623
Mailing address
28512 69TH PL, SALEM, WI 53168-9168
(262) 960-5623
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036050528
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036067511
—
IL
Enumeration date
09/20/2006
Last updated
04/22/2009
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