Organization
WIEGANDT AND ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIZBETH KAY ESTES (OFFICE MANAGER)
(508) 295-4902
Entity
Organization
Contact information
Practice address
2621 CRANBERRY HWY, WAREHAM, MA 02571-1004
(508) 295-4902
(508) 295-2455
Mailing address
2621 CRANBERRY HWY, WAREHAM, MA 02571-1004
(508) 295-4902
(508) 295-2455
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
57120
MA
302F00000X
Exclusive Provider Organization
Primary
57120
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285692525
—
MA
Enumeration date
07/08/2011
Last updated
12/08/2023
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