Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Eric Wideburg, DO

Individual provider Diagnostic Radiology Physician · NPI 1679004469

Eric Wideburg, DO is a Diagnostic Radiology in Waukesha, Wisconsin. Graduated from Des Moines University of Osteopathic Medicine and Health Sciences in 2017, 9 years ago. Practices with Lakeshore Medical Clinic LLC, a 379-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
9
Trained at
Des Moines University of Osteopathic Medicine and Health Sciences
Licensed in
WI
In the registry since
2017
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

W231N1440 Corporate Ct
Waukesha, WI 53186-1303
Phone: (262) 896-6000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 8701 W Watertown Plank Rd, Milwaukee, WI 53226-3548 — (414) 955-4575
  • 10945 N Port Washington Rd Ste 201, Thiensville, WI 53092-5078 — (262) 292-3151

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 72422-21 (WI)

Record details

NPI number1679004469
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedMarch 23, 2017
Last updated in NPPESMarch 27, 2025
Certification dateMarch 27, 2025
Mailing addressPo Box 735044, Chicago, IL 60673-5044

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolDES MOINES UNIVERSITY OF OSTEOPATHIC MEDICINE AND HEALTH SCIENCES
Graduated 2017 (9 years in practice)
Group practice Lakeshore Medical Clinic Llc — 379 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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