Individual
DR. ROBERT WILLIAM WIERENGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
125 S KALAMAZOO MALL STE 204, KALAMAZOO, MI 49007-4869
(269) 343-3900
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301092580
MI
Other
Enumeration date
06/30/2008
Last updated
03/11/2021
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