Individual
DR. JOHN ROBERT WICHERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
775 SW NINTH STREET, SUITE H, NEWPORT, OR 97365-4876
(541) 574-4767
(541) 574-4747
Mailing address
775 SW NINTH STREET, SUITE H, NEWPORT, OR 97365-4876
(541) 574-4767
(541) 574-4747
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
4301053932
MI
207V00000X
Obstetrics & Gynecology Physician
Primary
MD167094
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07-70022
PHP FAMILYCARE
MI
05
—
4679576
—
MI
05
—
500679017
—
OR
Enumeration date
06/07/2006
Last updated
10/22/2015
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