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Individual

DR. PETER J WIEBENGA

Active
Find providers by NPI
Individual

DR. PETER J WIEBENGA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
4301032024
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4301032024
PJW STATE
MI
01
—
P32249
PJW BCN
MI
01
—
PW032024
PJW BCBSMI
MI
Enumeration date
02/17/2006
Last updated
07/13/2026
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