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Individual

DR. WILLIAM DONALD WIERMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1008 MINNEQUA AVE, PUEBLO, CO 81004-3733
(719) 560-5656
(719) 560-4715
Mailing address
445 E CHEYENNE MOUNTAIN BLVD STE C PMB 406, COLORADO SPRINGS, CO 80906-4570
(719) 538-8100
(719) 538-8003

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
26727
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2370237
AETNA
CO
01
26727
COLORADO LICENSE
CO
01
84145895001
PACIFICARE
CO
05
85652571
CO
Enumeration date
07/09/2006
Last updated
03/07/2023
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