Individual
DR. WOLFGANG JOHANNES WEISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 S PROSPECT ST, 2318 REHAB.BLDG, UHC, BURLINGTON, VT 05401-3456
(802) 847-3572
Mailing address
136 N PROSPECT ST, BURLINGTON, VT 05401-3347
(802) 660-4910
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
E01434028
—
NY
05
—
OVN0717
—
VT
Enumeration date
10/17/2006
Last updated
07/08/2007
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