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Individual

KATHERINE ELEANOR WIEGMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
48 MAIN ST STE 3A, SENOIA, GA 30276-1895
(678) 723-0400
Mailing address
643 MAIN ST, PALMETTO, GA 30268-1138
(404) 929-8824
(404) 929-9769

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
067629
GA
207Q00000X
Family Medicine Physician
29748
NE
207Q00000X
Family Medicine Physician
67629
GA
207R00000X
Internal Medicine Physician
67629
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003124917C
GA
05
003124917D
GA
05
1881861839
NE
Enumeration date
05/09/2008
Last updated
07/21/2022
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