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NPI Code Detail

MEDICARE: RICHARD M WIECEK MD

MEDICARE: RICHARD M WIECEK 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
1208600000XSurgery Physician35084364OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
232012600600OTHEROHBWC

General Provider Information

NPI Number : 1831187087
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD M WIECEK MD
Provider Business Mailing Address
First Line : PO BOX 378
Second Line :
City : SANDUSKY
State : OH
Zip : 44871-0378
Country : US
Telephone Number : 419-609-1112
Fax Number : 419-609-1123
Provider Business Practice Location Address
First Line : 1479 N RIVER RD STE 120
Second Line :
City : FREMONT
State : OH
Zip : 43420-9760
Country : US
Telephone Number : 419-559-2814
Fax Number : 419-355-8490
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2005
Last Update Date : 03/17/2018

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Directions to “ RICHARD M WIECEK MD” Practice Location

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