Individual
DR. JOHN WALTER WIEST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1550 NE 27TH ST STE 100, BEND, OR 97701-7760
(541) 313-8111
(541) 313-8112
Mailing address
1550 NE 27TH ST STE 100, BEND, OR 97701-7760
(413) 138-1115
(541) 313-8112
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
MD14474
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
175216
—
OR
Enumeration date
12/30/2005
Last updated
02/11/2025
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