Glenn W Weidenbacher, MD - Pediatrics in Big Lake, MN

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Glenn W Weidenbacher, MD is a Pediatrics physician based in Big Lake, Minnesota. Glenn W Weidenbacher is licensed to practice in Minnesota (license number 48083) and his current practice location is 16830 198th Ave Nw, Big Lake Clinic, Big Lake, Minnesota. He can be reached at his office (for appointments etc.) via phone at (763) 263-7300.

NPI number for Glenn W Weidenbacher is 1801873674 and his current mailing address is 16830 198th Ave Nw, Big Lake Clinic, Big Lake, Minnesota. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1801873674.

Contact Information

Glenn W Weidenbacher, MD
16830 198th Ave Nw, Big Lake Clinic,
Big Lake, MN 55309
(763) 263-7300
(763) 263-7334

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Physician's Profile

Full NameGlenn W Weidenbacher
GenderMale
SpecialityPediatrics
Location16830 198th Ave Nw, Big Lake, Minnesota
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1801873674
  • Provider Enumeration Date: 12/22/2005
  • Last Update Date: 03/10/2008

Medical Identifiers

Medical identifiers for Glenn W Weidenbacher such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1801873674NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208000000XPediatrics 48083 (Minnesota)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Glenn W Weidenbacher is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Glenn W Weidenbacher, MD
16830 198th Ave Nw, Big Lake Clinic,
Big Lake, MN 55309

Ph: (763) 263-7300		Glenn W Weidenbacher, MD
16830 198th Ave Nw, Big Lake Clinic,
Big Lake, MN 55309

Ph: (763) 263-7300

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Pediatrics Doctors in Big Lake, MN


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