Individual
DR. BENJAMIN KANNENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1515 PARK AVE, COLUMBUS, WI 53925-2402
(920) 623-1200
Mailing address
1515 PARK AVE, COLUMBUS, WI 53925-2402
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
87287-20
WI
2084P0800X
Psychiatry Physician
Primary
U6266
TX
Other
Enumeration date
04/08/2022
Last updated
06/16/2026
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