Kiesnowski, Brian

Kiesnowski, Brian is an sole proprietor health care provider with primary practice located at 5605 Waterford Ln , Appleton WI 54913-8438. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic Surgery, which is considered as his primary health care specialty. Kiesnowski, Brian can be contacted via phone (920) 738-7200.

Contact Information

Primary practice address
5605 Waterford Ln Appleton WI 54913-8438
Fax: (920) 738-1906
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X 41995-020 Wisconsin

Profile Details

NPI number 1285607317
LBN Legal business name Kiesnowski, Brian
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 9th, 2006
Last updated Nov 19th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285607317 NPPES
Wisconsin MEDICAID 32627900

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