Individual
DR. KRISTEN E WUCKERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11300 E 13 MILE RD, STE 4A, WARREN, MI 48093-2500
(586) 574-1313
(586) 574-0842
Mailing address
11300 E 13 MILE RD, STE 4, WARREN, MI 48093-2500
(586) 574-1313
(586) 574-0842
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
4301070122
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4337874
—
MI
Enumeration date
11/14/2005
Last updated
10/04/2012
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