Wiese, Kathleen Marie
Wiese, Kathleen Marie is an individual health care provider with primary practice located at 3333 Silas Creek Pkwy , Winston Salem NC 27103-3013. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Vascular Neurology, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Neurology is her primary health care specialty. Wiese, Kathleen Marie can be contacted via phone (336) 718-7597.Contact Information
Primary practice address
3333 Silas Creek Pkwy
Winston Salem NC 27103-3013
Phone: (336) 718-7597
Fax: (336) 718-7598
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Vascular Neurology | 2084V0102X | 2007-01475 | North Carolina |
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 2007-01475 | North Carolina |
Profile Details
| NPI number | 1790987923 |
|---|---|
| LBN Legal business name | Wiese, Kathleen Marie |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 1st, 2007 |
| Last updated | Oct 25th, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790987923 | NPPES |
| North Carolina | Other | 2007-01475 | NC MED BOARD LICENSE |
| North Carolina | MEDICAID | 5907596 | NC MED BOARD LICENSE |
| North Carolina | Other | 1457P | NC MED BOARD LICENSE |
| North Carolina | Other | P00414192 | NC MED BOARD LICENSE |
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