Wiese, Michael B
Wiese, Michael B is an individual health care provider with primary practice located at 183 Intrepid Ln , Syracuse NY 13205-2548. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Wiese, Michael B can be contacted via phone (315) 251-0401.Contact Information
Primary practice address
183 Intrepid Ln
Syracuse NY 13205-2548
Phone: (315) 251-0401
Fax: (315) 251-0405
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 175162 | New York |
Profile Details
| NPI number | 1538137005 |
|---|---|
| LBN Legal business name | Wiese, Michael B |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 10th, 2006 |
| Last updated | Jan 22nd, 2010 - about 14 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 | 1538137005 | NPPES |
| New York | MEDICAID | 01499807 |
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