Individual
DR. NATHAN T. WEGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5718 NE SAPPHIRE PL, LEES SUMMIT, MO 64064-1177
(816) 718-2372
Mailing address
5718 NE SAPPHIRE PL, LEES SUMMIT, MO 64064-1177
(816) 718-2372
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2000153518
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27335011
BCBS
MO
01
—
P0002191
MEDICARE RR
MO
Enumeration date
05/24/2005
Last updated
03/23/2022
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