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NPI Code Detail

MEDICARE: DAVID A WIEBE M.D.

MEDICARE: DAVID A WIEBE 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
1207X00000XOrthopaedic Surgery Physician12637NE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
146969OTHERKSBCBS
21553OTHERNEBCBS
3645540OTHERKSFIRSTGUARD

General Provider Information

NPI Number : 1679576722
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID A WIEBE M.D.
Provider Business Mailing Address
First Line : PO BOX 2168
Second Line :
City : KEARNEY
State : NE
Zip : 68848-2168
Country : US
Telephone Number : 308-865-2512
Fax Number : 308-865-2506
Provider Business Practice Location Address
First Line : 3500 CENTRAL AVE
Second Line :
City : KEARNEY
State : NE
Zip : 68847-2944
Country : US
Telephone Number : 308-865-2512
Fax Number : 308-865-2506
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 07/08/2007

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