Individual
DR. BENJAMIN MICHAEL WIESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01083924A
IN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
35791
NE
207RP1001X
Pulmonary Disease Physician
Primary
35791
NE
Other
Enumeration date
04/29/2017
Last updated
03/25/2025
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