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NPI Code Detail

MEDICARE: ROSEMARY WIEGAND

MEDICARE:   ROSEMARY  WIEGAND
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
1207Q00000XFamily Medicine PhysicianMD061296LPA

General Provider Information

NPI Number : 1245239870
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROSEMARY WIEGAND
Provider Business Mailing Address
First Line : 1201 GRAMPIAN BLVD
Second Line :
City : WILLIAMSPORT
State : PA
Zip : 17701-1900
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1100 GRAMPIAN BLVD
Second Line :
City : WILLIAMSPORT
State : PA
Zip : 17701-1907
Country : US
Telephone Number : 570-320-7680
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2005
Last Update Date : 04/03/2024

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Directions to “ ROSEMARY WIEGAND ” Practice Location

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