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NPI Code Detail

MEDICARE: DR. DAVID C WENGER-KELLER MD

MEDICARE: DR. DAVID C WENGER-KELLER MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207K00000XAllergy & Immunology Physician036113262IL
2207K00000XAllergy & Immunology Physician35043843WOH
3207Q00000XFamily Medicine Physician25663IA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538157383
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID C WENGER-KELLER MD
Provider Business Mailing Address
First Line : 5409 AVENUE O
Second Line :
City : FORT MADISON
State : IA
Zip : 52627-9601
Country : US
Telephone Number : 319-376-2134
Fax Number : 319-376-2188
Provider Business Practice Location Address
First Line : 5409 AVENUE O
Second Line :
City : FORT MADISON
State : IA
Zip : 52627-9601
Country : US
Telephone Number : 319-376-2134
Fax Number : 319-376-2188
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2005
Last Update Date : 08/24/2010

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