MEDICARE: DR. DAVID M. WIECHEC 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	2085R0202X	Diagnostic Radiology Physician	120464-1	NY

General Provider Information

NPI Number	:	1518128537
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID M. WIECHEC M.D.

Provider Business Mailing Address
First Line	:	3495 BAILEY AVE
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14215-1129
Country	:	US
Telephone Number	:	716-834-9200
Fax Number	:

Provider Business Practice Location Address
First Line	:	3495 BAILEY AVE
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14215-1129
Country	:	US
Telephone Number	:	716-834-9200
Fax Number	:

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

Provider Enumeration Date	:	06/23/2008
Last Update Date	:	01/11/2026

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