Individual
DR. DAVID A WIESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9460 S SAGINAW RD STE D, GRAND BLANC, MI 48439-8207
(810) 733-7741
(810) 505-5021
Mailing address
3490 CALKINS RD, FLINT, MI 48532-3506
(810) 733-8885
(810) 733-8898
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
DW405105
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023126042
—
MI
05
—
2610466
—
MI
05
—
4515395
—
MI
05
—
4568693
—
MI
Enumeration date
08/29/2006
Last updated
05/29/2024
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