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General NPI Number Information
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NPI Number | 1699820217
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Entity Type | Organization
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Legal Business Name | ROBERT F SHAPIRO MD INC & KENNETH B WIESNER MD INC PTR
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 12/23/2020
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Provider Practice Location Address
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Address Line | 77 SCRIPPS DR STE 105
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City | SACRAMENTO
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State | CA
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Zip | 95825-6209
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Country | US
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Telephone | 916-922-7021
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Fax | 916-922-1080
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Provider Business Mailing Address
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Address Line | 77 SCRIPPS DR STE 105
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City | SACRAMENTO
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State | CA
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Zip | 95825-6209
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Country | US
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Telephone | 916-922-7021
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Fax | 916-922-1080
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Authorized Official
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Title or Position | PARTNER
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Name | DR. KENNETH B WIESNER
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Credential | M.D.
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Telephone | 916-922-7021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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