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NPI Code Detail

MEDICARE: MONICA HEIDI WICHNER DO

MEDICARE: MONICA HEIDI WICHNER DO
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
1208100000XPhysical Medicine & Rehabilitation Physician102881GA

General Provider Information

NPI Number : 1598758286
Entity Type Code : Individual
Provider Name (Legal Business Name) : MONICA HEIDI WICHNER DO
Provider Business Mailing Address
First Line : PO BOX 862
Second Line :
City : MCDONOUGH
State : GA
Zip : 30253-0862
Country : US
Telephone Number : 775-443-2260
Fax Number :
Provider Business Practice Location Address
First Line : 2200 PATRICK HENRY PKWY
Second Line :
City : MCDONOUGH
State : GA
Zip : 30253-4207
Country : US
Telephone Number : 775-443-2260
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2005
Last Update Date : 02/20/2025

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Directions to “ MONICA HEIDI WICHNER DO” Practice Location

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