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General NPI Number Information
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NPI Number | 1578599486
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Entity Type | Individual
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Provider Name | GEORGE EDWARD WIGGINS M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/23/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 9621 RIDGETOP BLVD NW
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City | SILVERDALE
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State | WA
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Zip | 98383-8502
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Country | US
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Telephone | 360-782-3400
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Fax | 360-782-3450
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Provider Business Mailing Address
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Address Line | 9621 RIDGETOP BLVD NW
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City | SILVERDALE
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State | WA
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Zip | 98383-8502
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Country | US
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Telephone | 360-782-3300
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Fax | 360-782-3689
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD00025064
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License Number State | WA
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