Individual
TIMOTHY J WIEGAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
601 ELMWOOD AVE, BOX 655, ROCHESTER, NY 14642-8655
(585) 275-9555
Mailing address
601 ELMWOOD AVE, BOX 655, ROCHESTER, NY 14642-8655
(585) 275-9555
Taxonomy
Speciality
Code
Description
License number
State
207PT0002X
Medical Toxicology (Emergency Medicine) Physician
017860
ME
207PT0002X
Medical Toxicology (Emergency Medicine) Physician
Primary
258256
NY
207R00000X
Internal Medicine Physician
017860
ME
207R00000X
Internal Medicine Physician
A88509
CA
208M00000X
Hospitalist Physician
017860
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03257283
—
NY
05
—
30207895
—
NH
05
—
432977599
—
ME
Enumeration date
08/18/2006
Last updated
07/06/2023
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