Individual
ETHAN RON WIESLER
Active
Individual
ETHAN RON WIESLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
9600222
NC
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
96-00222
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
126FF
BCBS
—
05
—
1850002000
—
WV
01
—
200043944
RR MEDICARE
—
01
—
2280373A
MEDCIARE
NC
01
—
36195
PARTNERS
—
05
—
6402941
—
VA
01
—
7122310
AETNA
—
05
—
89126FF
—
NC
01
—
98579
MEDCOST
—
Enumeration date
12/23/2005
Last updated
08/20/2020
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