Glenn W Weidenbacher, MD

NPI #1801873674 in Big Lake, Minnesota

Provider Information

NPI Number: 1801873674
Entity Type: Individual
Name: Glenn W Weidenbacher, MD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pediatrics
Credential: MD
Enumeration Date: Dec 22, 2005
Last Updated: Mar 10, 2008

Practice Location

Address: 16830 198TH AVE NW
Address 2: BIG LAKE CLINIC
City: Big Lake
State: Minnesota
ZIP Code: 55309
Phone: (763) 263-7300

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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