Individual
DR. LAWRENCE JOSEPH WIELAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2350 BUHNE ST, A, EUREKA, CA 95501-3238
(707) 443-4593
(707) 443-6447
Mailing address
2350 BUHNE ST, A, EUREKA, CA 95501-3238
(707) 443-4593
(707) 443-6447
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
C36056
CA
208D00000X
General Practice Physician
Primary
C36056
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C360560
—
CA
01
—
C36056
MEDICAL LICENSE
CA
Enumeration date
10/19/2005
Last updated
01/12/2011
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