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Individual

MR. RICHARD A. WIEMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
57 WATER STREET, BLUE HILL, ME 04614
(207) 374-3911
(207) 374-3986
Mailing address
PO BOX 1029, BLUE HILL, ME 04614-1029
(207) 374-3911
(207) 374-3986

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-342
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
287100099
ME
01
AP041801
MED B - MCMH
ME
01
AP041802
MED B - MCMH
ME
Enumeration date
07/05/2006
Last updated
12/14/2009
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