Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 28714-020 | WI |
Y | 207QA0401X | Family Doctor - Addiction Medicine | 28714-020 | WI |
N | 207QS0010X | Family Doctor - Sports Medicine | 28714-020 | WI |
NPI | 1811926819 |
---|---|
Provider Name | Donald Weinmeister |
First Address | Green Bay, WI 54307-9070 |
Second Address | Chippewa Falls, WI 54729-2785 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2006 |
Last Update Date | 27/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
31509500 | (05) | WI |
B85345 | (02) |