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General NPI Number Information
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NPI Number | 1356449771
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Entity Type | Individual
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Provider Name | ROBERT D WIELE MD
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Gender | Male
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 04/22/2008
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Provider Practice Location Address
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Address Line | 2 PROGRESS POINT CT PROGRESS WEST HEALTH CENTER
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City | O FALLON
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State | MO
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Zip | 63368-2208
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Country | US
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Telephone | 314-740-6471
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Fax |
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Provider Business Mailing Address
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Address Line | 5 GARDEN LN
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City | KIRKWOOD
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State | MO
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Zip | 63122-2636
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Country | US
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Telephone | 314-821-6471
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Fax |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | R9840
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License Number State | MO
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