Individual
KYLE J WESLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
615 N MICHIGAN ST, SOUTH BEND, IN 46601-1033
(574) 647-7458
Mailing address
615 N MICHIGAN ST, SOUTH BEND, IN 46601-1033
(248) 410-4976
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
02006637A
IN
207P00000X
Emergency Medicine Physician
5315091412
MI
Other
Enumeration date
04/30/2018
Last updated
06/07/2022
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