Wiesenauer, Chad A

Wiesenauer, Chad A is an sole proprietor health care provider with primary practice located at 234 E Gray St , Louisville KY 40202-1900. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Surgery, which is considered as his primary health care specialty. Wiesenauer, Chad A can be contacted via phone (502) 588-0390.

Contact Information

Primary practice address
234 E Gray St Louisville KY 40202-1900
Phone: (502) 588-0390
Fax: (502) 584-5437
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Surgery 2086S0120X 01053500A Indiana

Profile Details

NPI number 1861616732
LBN Legal business name Wiesenauer, Chad A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 12th, 2007
Last updated Oct 9th, 2017 - about 9 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 1861616732 NPPES
Indiana Other 01053500A STATE LICENSE NUMBER
Indiana MEDICAID 7100008600 STATE LICENSE NUMBER

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