Individual
DR. BRIAN J WIEGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5901 TECHNOLOGY CENTER DR, INDIANAPOLIS, IN 46278-6013
(317) 328-5050
(317) 715-9965
Mailing address
5901 TECHNOLOGY CENTER DR, INDIANAPOLIS, IN 46278-6013
(317) 328-5050
(317) 715-9965
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01040536A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000082131
ANTHEM-351158723
IN
01
—
000000492370
ANTHEM 203778927
IN
01
—
002095
SIHO-351158723
IN
01
—
059333
HEALTH ALLIANCE-351158723
IN
05
—
200035270
—
IN
01
—
300100874
RR MEDICARE-351158723
IN
01
—
Q0084960
CMOSHO351158723&352047427
IN
Enumeration date
12/15/2005
Last updated
12/04/2009
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