Individual
CHARMAINE WIENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
132 S 10TH ST, SUITE 1085 MAIN, DEPT OF RADIOLOGY, THOMAS JEFFERSON, PHILADELPHIA, PA 19107-5244
(215) 955-0420
Mailing address
132 S 10TH ST, SUITE 1085 MAIN, DEPT OF RADIOLOGY, THOMAS JEFFERSON, PHILADELPHIA, PA 19107-5244
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MT203767
PA
Other
Enumeration date
04/14/2014
Last updated
04/14/2014
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