Individual
MRS. MADELINE MARIE WIECHEC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
67 PRESIDENT ST # 861, CHARLESTON, SC 29425
(843) 792-9888
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2934
SC
363A00000X
Physician Assistant
MA059563
PA
Other
Enumeration date
11/07/2017
Last updated
04/30/2019
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