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Organization
MEGAN S K WIESE MD PC
Active
Organization
MEGAN S K WIESE MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUG WIESE (OFFICE MANAGER)
(928) 854-6249
Entity
Organization
Contact information
Practice address
2130 MESQUITE AVE UNIT 106, LAKE HAVASU CITY, AZ 86403-6897
(928) 854-6249
(928) 854-6301
Mailing address
2130 MESQUITE AVE UNIT 106, LAKE HAVASU CITY, AZ 86403-6897
(928) 854-6249
(928) 854-6301
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
29168
AZ
Other
Enumeration date
01/08/2008
Last updated
10/02/2012
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