Individual
DR. JAMES ALAN WIESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
24575
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0057497
—
IA
05
—
0081794
—
IA
01
—
19476
BLUE CROSS BLUE SHIELD
IA
01
—
27997
BLUE CROSS BLUE SHIELD
IA
05
—
3081794
—
IA
01
—
32811
BLUE CROSS BLUE SHIELD
IA
01
—
42859
BLUE CROSS BLUE SHIELD
IA
Enumeration date
05/26/2006
Last updated
04/27/2021
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