Individual
DR. MEGAN SK WIESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2130 MESQUITE AVE UNIT 106, LAKE HAVASU CITY, AZ 86403-6897
(928) 854-6249
(928) 854-6301
Mailing address
2130 MESQUITE AVE UNIT 106, LAKE HAVASU CITY, AZ 86403-6897
(928) 854-6249
(928) 854-6301
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
29168
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
577091
—
AZ
01
—
AZ0735830
BCBS
AZ
Enumeration date
08/05/2006
Last updated
12/13/2024
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