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General NPI Number Information
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NPI Number | 1619974243
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Entity Type | Individual
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Provider Name | CARLOS A WIEGERING MD
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Gender | Male
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Dates
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Enumeration Date | 06/28/2005
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Last Update Date | 02/24/2010
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Provider Practice Location Address
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Address Line | 200 HOSPITAL DR SUITE 3
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City | TYRONE
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State | PA
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Zip | 16686-1825
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Country | US
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Telephone | 814-684-4472
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Fax | 814-684-4780
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Provider Business Mailing Address
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Address Line | 200 HOSPITAL DR SUITE 3
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City | TYRONE
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State | PA
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Zip | 16686-1825
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Country | US
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Telephone | 814-684-4472
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Fax | 814-684-4780
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | MD019247E
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License Number State | PA
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