Kevin John Wickenheiser, M.D.

NPI #1043506520 in Detroit, Michigan

Provider Information

NPI Number: 1043506520
Entity Type: Individual
Name: Kevin John Wickenheiser, M.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Emergency Medicine
Credential: M.D.
Enumeration Date: Jun 23, 2011
Last Updated: Jun 23, 2011

Practice Location

Address: 2799 W GRAND BLVD
City: Detroit
State: Michigan
ZIP Code: 48202-2608
Phone: (313) 622-6170

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Emergency Medicine	207P00000X	Primary

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