Individual
MR. KEVIN WALTER WENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
430 BATH RD STE 102, BRUNSWICK, ME 04011-2656
(207) 442-0350
(207) 618-5668
Mailing address
430 BATH RD STE 102, BRUNSWICK, ME 04011-2656
(207) 442-0350
(207) 618-5668
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA2143
ME
363A00000X
Physician Assistant
PA6455
MA
363AM0700X
Medical Physician Assistant
PA6455
MA
363AS0400X
Surgical Physician Assistant
Primary
PA2143
ME
363AS0400X
Surgical Physician Assistant
PA6455
MA
Other
Enumeration date
04/30/2018
Last updated
05/22/2025
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