Brent M Wiersema in Traverse City - Orthopaedic Trauma
Brent M Wiersema - NPI 1790709632
Brent M Wiersema is a Orthopaedic Trauma in Traverse City, Michigan. Brent M Wiersema practices all healthcare services and medical treatments related to Orthopaedic Trauma. The NPI Number for Brent M Wiersema is 1790709632. The last update date is 2020-12-31.
Brent M Wiersema's current location address is 4045 W Royal Dr, Traverse City, Michigan. You can contact this provider via phone number 2319350900 and fax number 2309350308. The mailing address for Brent M Wiersema is 4045 W Royal Dr, Traverse City, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Brent M Wiersema |
|---|---|
| Address | 4045 W Royal Dr, Traverse City, Michigan |
| Phone Number | 2319350900 |
| Fax Number | 2309350308 |
| Sole Proprietor | N |
| Credentials | D.O. |
NPI Number Detail
| NPI Number | 1790709632 |
|---|---|
| Provider Enumeration Date | 2006-07-26 |
| Last Updated Date | 2020-12-31 |
Provider Mailing Address Detail
| Address | 4045 W Royal Dr |
|---|---|
| City | Traverse City |
| State | Michigan (MI) |
| Post Code | 496848965 |
| Phone Number | 2319350900 |
| Fax Number | 2309350308 |
Provider's Primary Taxonomy Detail
| Speciality | Orthopaedic Trauma |
|---|---|
| Taxonomy | 207Xx0801X |
| Licence No | 5101014182 |
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Definition: Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic trauma surgeons deal with the evaluation and management of acute orthopaedic injuries, evaluation and treatment of post-traumatic defo |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 114768380 | MI | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Brent M Wiersema by the Centers for Medicare & Medicaid Services (CMS)?
The Brent M Wiersema has been assigned the NPI (National Provider Identifier) 1790709632. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you please share the complete physical location address where Brent M Wiersema's facilities are situated?
The facilities of Brent M Wiersema are physically located at the following address: 4045 W Royal Dr, Traverse City, MI, 496848965.
What is the Brent M Wiersema's specialty and taxonomy code?
The Brent M Wiersema's specialty is Orthopaedic Trauma, and the corresponding taxonomy code is 207Xx0801X.
On what date did the Centers for Medicare & Medicaid Services issue the 1790709632 to Brent M Wiersema?
The Brent M Wiersema received its 1790709632 assignment from the Centers for Medicare & Medicaid Services on 2006-07-26.
As of what date were the details pertaining to Brent M Wiersema last refreshed?
The information related to the Brent M Wiersema, including its address, specialty, and other relevant details, was last updated on 2020-12-31.