Wiese, Matthew L.
Wiese, Matthew L. is an individual health care provider with primary practice located at 818 Ellicott St , Buffalo NY 14203-1021. He recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine, Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine is his primary health care specialty. Wiese, Matthew L. can be contacted via phone (716) 323-2000.Contact Information
Primary practice address
818 Ellicott St
Buffalo NY 14203-1021
Phone: (716) 323-2000
Fax: (716) 323-0293
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 274395 | Massachusetts |
| Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine | 2080P0203X | 298763 | New York |
| Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine | 2080P0204X | 274395 | Massachusetts |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine | 2080P0204X | 298763 | New York |
Profile Details
| NPI number | 1316333446 |
|---|---|
| LBN Legal business name | Wiese, Matthew L. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 15th, 2015 |
| Last updated | Jun 6th, 2023 - about last year |
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 | 1316333446 | NPPES |
| New York | MEDICAID | 06949971 |
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