Individual
BRIAN J WIECZOREK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1086 FRANKLIN ST, CONEMAUGH EMERGENCY PHYSICIANS GROUP, JOHNSTOWN, PA 15905
(814) 534-9600
Mailing address
551 MAIN ST 3RD FLOOR ATTN NICOLLE, THE INFORMEDX GROUP, JOHNSTOWN, PA 15901
(814) 539-5724
(814) 536-7092
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD066165L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001722056
—
PA
Enumeration date
03/10/2006
Last updated
03/08/2013
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