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

Individual provider Emergency Medicine Physician · NPI 1043506520

Kevin John Wickenheiser, MD is an Emergency Medicine in Detroit, Michigan. Graduated from Wayne State University School of Medicine in 2011, 15 years ago. Practices with Mercy Emergency Care Services Inc, a 64-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
15
Trained at
Wayne State University School of Medicine
Licensed in
MI
In the registry since
2011
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone: (313) 622-6170
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 4301098989 (MI)

Record details

NPI number1043506520
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 23, 2011
Last updated in NPPESJune 23, 2011

Medicare enrollment

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

Medicare specialtyEMERGENCY MEDICINE
Medical schoolWAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Graduated 2011 (15 years in practice)
Group practice Mercy Emergency Care Services Inc — 64 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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