Individual
DR. CARLOS A WIEGERING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 HOSPITAL DR, SUITE 3, TYRONE, PA 16686-1825
(814) 684-4472
(814) 684-4780
Mailing address
200 HOSPITAL DR, SUITE 3, TYRONE, PA 16686-1825
(814) 684-4472
(814) 684-4780
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
MD019247E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005918710002
—
PA
01
—
441021880
RR MEDICARE
PA
Enumeration date
06/28/2005
Last updated
02/24/2010
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