MEDICARE: DR. ROBB JAY WIEGAND M.D.

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	207P00000X	Emergency Medicine Physician	2012-00030	NC

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	:	1336135359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBB JAY WIEGAND M.D.

Provider Business Mailing Address
First Line	:	PO BOX 602598
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28260-2598
Country	:	US
Telephone Number	:	336-716-2255
Fax Number	:

Provider Business Practice Location Address
First Line	:	1240 HUFFMAN MILL RD
Second Line	:	ALAMANCE REGIONAL MEDICAL CENTER
City	:	BURLINGTON
State	:	NC
Zip	:	27215-8700
Country	:	US
Telephone Number	:	336-538-7000
Fax Number	:

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

Provider Enumeration Date	:	09/26/2005
Last Update Date	:	01/28/2013

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