Organization
KURT WIESE, MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KURT WIESE M.D (OWNER)
(219) 462-7773
Entity
Organization
Contact information
Practice address
401 WALL ST, SUITE B, VALPARAISO, IN 46383-2521
(219) 462-7773
(219) 531-5988
Mailing address
401 WALL ST, SUITE B, VALPARAISO, IN 46383-2521
(219) 462-7773
(219) 531-5988
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01040290
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000091658
ANTHEM
IN
Enumeration date
01/17/2008
Last updated
02/11/2025
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