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General NPI Number Information
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NPI Number | 1316996119
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Entity Type | Individual
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Provider Name | NELSON E. WIEGMAN MD
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Gender | Male
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Dates
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Enumeration Date | 05/09/2006
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Last Update Date | 05/19/2020
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Provider Practice Location Address
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Address Line | 7785 N STATE ST STE 120
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City | LOWVILLE
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State | NY
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Zip | 13367-1229
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Country | US
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Telephone | 315-376-4505
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Fax | 315-376-4259
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Provider Business Mailing Address
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Address Line | 7785 N STATE ST STE 120
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City | LOWVILLE
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State | NY
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Zip | 13367-1297
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Country | US
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Telephone | 315-376-4505
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Fax | 315-376-4259
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | C1-0003720
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | D83131
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 303847
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License Number State | NY
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