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Individual
MICHAEL G WIERSCHEM
Active
Individual
MICHAEL G WIERSCHEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
K7120
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104042004
—
TX
05
—
104042005
—
TX
01
—
751531693
TAX ID #
TX
01
—
8B6833
MEDICARE PTAN
—
01
—
P01843066
RAILROAD
TX
Enumeration date
09/14/2006
Last updated
04/13/2018
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