Individual
DR. WILLIAM ROBERT WIEGMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1034 CARLL DR, BAY SHORE, NY 11706-6204
(631) 665-1614
Mailing address
1034 CARLL DR, BAY SHORE, NY 11706-6204
(631) 665-1614
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
N004162-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00966885
—
NY
Enumeration date
05/19/2007
Last updated
07/09/2007
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