Organization
JEANNE S. VEDDER M.D SC
Active
Organization
JEANNE S. VEDDER M.D SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEANNE S. VEDDER M.D. (PRESIDENT)
(262) 657-6577
Entity
Organization
Contact information
Practice address
1400-75 STREET, SUITE 4, KENOSHA, WI 53143-1522
(262) 657-6577
(262) 657-7844
Mailing address
1400-75 STREET, SUITE 4, KENOSHA, WI 53143-1522
(262) 657-6577
(262) 657-7844
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1000086
UNITED HEALTHCARE
WI
01
—
1532113
UNITED MINE WORKERS
WI
05
—
31564000
—
WI
01
—
396608943E04
BLUE CROSS BLUE SHIELD
WI
Enumeration date
10/24/2006
Last updated
10/11/2007
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