Individual
DR. ROBERT WILLIAM WEGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
46215
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103I026675
PROVIDER TRANSACTION ACCOUNT NUMBER (PTAN)
TN
Enumeration date
06/25/2009
Last updated
03/09/2011
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