Individual
DR. PAUL J. WIEGAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
549 FAIR ST, BLOOMSBURG, PA 17815-1419
(570) 387-2147
(570) 387-2042
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
(570) 271-6578
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD060700L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001655730
—
PA
Enumeration date
05/16/2006
Last updated
11/14/2018
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