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General NPI Number Information
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NPI Number | 1598286940
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Entity Type | Individual
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Provider Name | DIANE MARIE KUEHL MD
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Gender | Female
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Dates
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Enumeration Date | 07/06/2017
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Last Update Date | 06/07/2024
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Provider Practice Location Address
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Address Line | 22 OLD WATERBURY RD
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City | SOUTHBURY
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State | CT
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Zip | 06488-3848
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Country | US
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Telephone | 203-262-4200
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Fax |
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Provider Business Mailing Address
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Address Line | 5008 N MARY MARTIN DR
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City | APPLETON
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State | WI
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Zip | 54913-8061
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Country | US
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Telephone | 616-227-9439
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 73822
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301113414
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 73822
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 78134
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License Number State | CT
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