Individual
KEVIN WIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
5701 BOW POINTE DR STE 100, CLARKSTON, MI 48346-3199
(248) 625-2621
(248) 625-2622
Mailing address
5701 BOW POINTE DR STE 100, CLARKSTON, MI 48346-3199
(248) 625-2621
(248) 625-2622
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101027461
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/05/2019
Last updated
04/23/2024
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