Provider Demographics
NPI:1609842335
Name:WEHSELER, RICHARD A (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:A
Last Name:WEHSELER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 PETERSON PKWY
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:MN
Mailing Address - Zip Code:56273-7823
Mailing Address - Country:US
Mailing Address - Phone:320-354-2222
Mailing Address - Fax:320-354-2274
Practice Address - Street 1:600 PETERSON PKWY
Practice Address - Street 2:
Practice Address - City:NEW LONDON
Practice Address - State:MN
Practice Address - Zip Code:56273-7823
Practice Address - Country:US
Practice Address - Phone:320-354-2222
Practice Address - Fax:320-354-2274
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN38937207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN166023300Medicaid
MN080008193Medicare ID - Type Unspecified
G32363Medicare UPIN