Individual
GERI ANN WIELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2125 RIDGEWOOD DR, MIDLAND, MI 48642-5836
(989) 254-6427
(989) 607-1314
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601005609
MI
363AS0400X
Surgical Physician Assistant
002045
IA
Other
Enumeration date
10/19/2009
Last updated
07/21/2022
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