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General NPI Number Information
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NPI Number | 1427289164
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Entity Type | Organization
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Legal Business Name | PAULA E. WEGERT, MD, PROFESSIONAL LLC
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Dates
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Enumeration Date | 07/29/2009
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Last Update Date | 07/29/2009
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Provider Practice Location Address
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Address Line | 790 POLLUX DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-1084
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Country | US
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Telephone | 210-241-6810
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Fax |
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Provider Business Mailing Address
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Address Line | 790 POLLUX DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-1084
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Country | US
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Telephone | 210-241-6810
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | PAULA ELAINE WEGERT
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Credential | MD
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Telephone | 210-241-6810
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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