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Individual

KEVIN A. WEIDMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
950 N. 35TH STREET, MILWAUKEE, WI 53208
(414) 831-7939
(414) 831-7954
Mailing address
950 N. 35TH STREET, MILWAUKEE, WI 53208
(414) 831-7939
(414) 831-7954

Taxonomy

Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
36166
WI
207XS0106X
Orthopaedic Hand Surgery Physician
36166 HAND SURGERY
WI
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
36166
WI
208600000X
Surgery Physician
36166
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
32135100
WI
Enumeration date
05/19/2006
Last updated
07/21/2016
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