Individual
JAMES ROGER WIEFERICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
40 WHITE OAK PROFESSIONAL CTR, VINCENT, OH 45784-9117
(740) 678-2374
(740) 678-8139
Mailing address
PO BOX 449, MARIETTA, OH 45750-0449
(740) 374-4500
(740) 374-5887
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3506005
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000678794
ANTHEM
OH
01
—
000000699796
ANTHEM
OH
05
—
0052785000
—
WV
05
—
0790916
—
OH
01
—
P01019339
MCR RAILROAD
OH
Enumeration date
03/15/2006
Last updated
05/11/2012
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