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NPI Code Detail

MEDICARE: DR. ANDREW J WEDDLE D.O.

MEDICARE: DR. ANDREW J WEDDLE D.O.
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
1207P00000XEmergency Medicine Physician53366WI
2207P00000XEmergency Medicine Physician5101016338MI

General Provider Information

NPI Number : 1831395888
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANDREW J WEDDLE D.O.
Provider Business Mailing Address
First Line : 3 NEENAH CTR
Second Line :
City : NEENAH
State : WI
Zip : 54956-3070
Country : US
Telephone Number : 920-830-5900
Fax Number : 920-830-5910
Provider Business Practice Location Address
First Line : 800 RIVERSIDE DR
Second Line :
City : WAUPACA
State : WI
Zip : 54981-1943
Country : US
Telephone Number : 715-258-1041
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2007
Last Update Date : 03/04/2026

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