Individual
DR. GERALD VINCENT WIEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
HQ AFIA 9700 G AVE.SE, BLDG. 24499, KIRTLAND AIR FORCE BASE, NM 87117-5522
(508) 246-2486
Mailing address
HQ AFIA, 9700 G AVE SE, BLDG 24499, KIRTLAND AIR FORCE BASE, NM 87117-5522
(702) 540-5808
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D. O. 716
NV
Other
Enumeration date
01/11/2006
Last updated
06/22/2012
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