Individual
DR. KENNETH FRED WENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
274 N MAIN STREET, HEPPNER, OR 97836
(541) 676-5440
(541) 676-8036
Mailing address
PO BOX 9, HEPPNER, OR 97836-0009
(541) 676-2942
(541) 676-2901
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD14131
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130039
—
OR
Enumeration date
06/28/2006
Last updated
10/07/2015
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