Provider Demographics
NPI:1629365507
Name:WEDEL, WHITNEY R (MD)
Entity Type:Individual
Prefix:DR
First Name:WHITNEY
Middle Name:R
Last Name:WEDEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3005 HARNEY ST
Mailing Address - Street 2:APT B2
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-3538
Mailing Address - Country:US
Mailing Address - Phone:913-660-5737
Mailing Address - Fax:
Practice Address - Street 1:3005 HARNEY ST
Practice Address - Street 2:APT B2
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-3538
Practice Address - Country:US
Practice Address - Phone:913-660-5737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-29
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE6614207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology