MEDICARE: DR. ROBBY J WIEMER DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	SC004761L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275532079
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBBY J WIEMER DPM

Provider Business Mailing Address
First Line	:	850 W CHESTER PIKE
Second Line	:	SUITE 200
City	:	HAVERTOWN
State	:	PA
Zip	:	19083-4400
Country	:	US
Telephone Number	:	484-453-8164
Fax Number	:	484-453-8291

Provider Business Practice Location Address
First Line	:	850 W CHESTER PIKE
Second Line	:	SUITE 200
City	:	HAVERTOWN
State	:	PA
Zip	:	19083-4400
Country	:	US
Telephone Number	:	484-453-8164
Fax Number	:	484-453-8291

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	02/28/2012

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