MEDICARE: DR. STEPHEN W WEGNER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	10600	MT

General Provider Information

NPI Number	:	1114088259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN W WEGNER MD

Provider Business Mailing Address
First Line	:	PO BOX 1113
Second Line	:
City	:	CUT BANK
State	:	MT
Zip	:	59427-1113
Country	:	US
Telephone Number	:	406-450-1754
Fax Number	:

Provider Business Practice Location Address
First Line	:	109 1ST AVE SE
Second Line	:
City	:	CUT BANK
State	:	MT
Zip	:	59427-3208
Country	:	US
Telephone Number	:	406-450-1754
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	07/17/2024

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