Individual
SAMANTHA LYNN WIEGAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1 WYOMING ST, BERRY BLDG, GROUND FLOOR, DAYTON, OH 45409-2722
(937) 208-2516
(937) 208-6124
Mailing address
1 WYOMING ST, BERRY BLDG, GROUND FLOOR, DAYTON, OH 45409-2722
(937) 208-2516
(937) 208-6124
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
2012-00087
NC
207VM0101X
Maternal & Fetal Medicine Physician
Primary
35.085836
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2839861
—
OH
Enumeration date
11/13/2006
Last updated
08/26/2015
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