Individual
SUSAN H WIEBE
Active
Individual
SUSAN H WIEBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
30484
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104615
BCBS
KS
01
—
107906
HPK
KS
01
—
12381073
MULTIPLAN
KS
05
—
200316370A
—
KS
01
—
236567
COVENTRY
KS
01
—
8859
PHS
KS
Enumeration date
08/06/2006
Last updated
10/21/2015
Update your record
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