Individual
DR. STEWART E WIEGAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
755 MT VERNON HIGHWAY, SUITE 110, ATLANTA, GA 30328-4276
(404) 256-9692
(404) 256-9404
Mailing address
401 S MAIN ST, SUITE A2, ALPHARETTA, GA 30009-1974
(404) 256-9692
(404) 256-9404
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
012988
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00176481C
—
GA
01
—
CM5399
RAILROAD MEDICARE
GA
Enumeration date
11/02/2005
Last updated
04/08/2014
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