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Individual

BRANDON WIBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 962-6793
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
02008369A
IN
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
03/26/2020
Last updated
10/21/2025
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