Individual
NICHOLAS WEGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
22 CORPORATE PLAZA DR, NEWPORT BEACH, CA 92660-7985
(949) 722-7038
(949) 630-4900
Mailing address
22 CORPORATE PLAZA DR, NEWPORT BEACH, CA 92660-7985
(949) 722-7038
(949) 630-4900
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
28465
NE
207X00000X
Orthopaedic Surgery Physician
Primary
A137540
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100258006-00
—
NE
01
—
1699917492
WELLMARK BCBS OF IA
IA
01
—
1699917492
BCBS OF NE
NE
05
—
1699917492
—
IA
05
—
470630101-13
—
NE
01
—
60258658
ARBOR HEALTH
NE
Enumeration date
03/25/2009
Last updated
01/08/2024
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