Suzanne Wehrenberg, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301042419 Issued in MI

Practice address

4048 Cedar Bluff Drive
Suite 5
Petoskey, MI 49770-8895

Phone

(231) 348-1880

Fax

(231) 348-0905

NPI assigned

Oct 24, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233705600000",
    "number": "1023192564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4048 CEDAR BLUFF DRIVE",
            "address_2": "SUITE 5",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497708895",
            "telephone_number": "231-348-1880",
            "fax_number": "231-348-0905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4048 CEDAR BLUFF DRIVE",
            "address_2": "SUITE 5",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497708895",
            "telephone_number": "231-348-1880",
            "fax_number": "231-348-0905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEHRENBERG",
        "first_name": "SUZANNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2009-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301042419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0102410062",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023192564",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Carolyn Marie Wiese, PA
• Taryn Deborah Wiggins

• Family Medicine Physician in Petoskey, MI
• Providers in Petoskey, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.