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GLENN W WEIDENBACHER MD
NPI 1801873674
Pediatrics in Big Lake, MN

Active since December 22, 2005
16830 198TH AVE NW, BIG LAKE CLINIC, BIG LAKE, MN 55309(763) 263-7300(763) 263-7334 Get Directions Write a Review

NPPES record last updated: March 10, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Glenn W Weidenbacher Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GLENN W WEIDENBACHER MD (NPI 1801873674) is an individual pediatrics provider in Big Lake, Minnesota, licensed in Minnesota (48083) and active in the NPI registry since December 2005.

NPPES Registry Identity

NPI1801873674
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameGLENN W WEIDENBACHERCredential: MD
Location Address16830 198TH AVE NW, BIG LAKE CLINICBig Lake, MN 55309
Mailing Address16830 198th Ave Nw, Big Lake ClinicBig Lake, MN 55309 · (763) 263-7300
Phone(763) 263-7300
Fax(763) 263-7334
Sole ProprietorNo
Enumeration DateDecember 22, 2005
Last NPPES UpdateMarch 10, 2008
✔ NPI 1801873674 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in MN · 48083
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
16830 198TH AVE NW, Big Lake, MN 55309
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Other Identifiers 1

Medicare UPINH26490

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CENTRACARE CLINIC
Clinic/Center (Multi-Specialty)
16830 198TH AVE NW, CENTRACARE CLINIC - BIG LAKE
BIG LAKE, MN 55309
Sherburne County (763) 263-7300
NABEEL BISHARA AILABOUNI DO
Family Medicine
16830 198TH AVE NW, BIG LAKE CLINIC
BIG LAKE, MN 55309
Sherburne County (763) 263-7300
LOLA B SUTHERLAND MD
Family Medicine
16830 198TH AVE NW, BIG LAKE CLINIC
BIG LAKE, MN 55309
Sherburne County (763) 263-7300
LUKE A. HERDINA P.A.-C
Physician Assistant (Medical)
16830 198TH AVE NW, BIG LAKE CLINIC
BIG LAKE, MN 55309
Sherburne County (763) 263-7300
FRESENIUS MEDICAL CARE CENTRACARE DIALYSIS, LLC
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
16830 198TH AVE NW
BIG LAKE, MN 55309
Sherburne County (763) 263-7320

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Glenn Weidenbacher's NPI number?

The NPI number for Glenn Weidenbacher is 1801873674. It was assigned to this individual provider in the NPPES registry on December 22, 2005.

Where is Glenn Weidenbacher located?

Glenn Weidenbacher practices at 16830 198th Ave NW Big Lake Clinic, Big Lake, MN 55309. The listed phone number is (763) 263-7300.

What is Glenn Weidenbacher's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

When was this NPI record last updated?

The NPPES record for Glenn Weidenbacher was last updated on March 10, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.