Individual
DR. CHRISTIAN WIGHTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
61 STATE STREET, NUNDA, NY 14517-9785
(585) 468-2528
(585) 468-5424
Mailing address
PO BOX 601, 10869 RTE 36 SOUTH, DANSVILLE, NY 14437-0601
(585) 335-3416
(585) 335-8695
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
256177
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03348941
—
NY
01
—
J100000262
MEDICARE PTAN
NY
Enumeration date
04/28/2008
Last updated
03/02/2012
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