Individual
TRAVIS ROBERT WIELAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4300 MARKETPOINTE DR STE 100, BLOOMINGTON, MN 55435-5435
(952) 835-9880
(952) 857-1554
Mailing address
4300 MARKETPOINTE DR STE 100, BLOOMINGTON, MN 55435-5435
(952) 835-9880
(952) 857-1554
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
71722
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/27/2018
Last updated
03/16/2023
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