Individual
DR. JOHN M WIECHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
850 HARRISON AVE, YACC 4, BOSTON, MA 02118-4001
(617) 414-2080
(617) 414-2090
Mailing address
720 HARRISON AVE, DOB 503, BOSTON, MA 02118
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
60532
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110057551A
—
MA
Enumeration date
02/15/2006
Last updated
05/05/2014
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