Carolyn Marie Wiese in Petoskey - Physician Assistant
Carolyn Marie Wiese - NPI 1235130576
Carolyn Marie Wiese is a Physician Assistant in Petoskey, Michigan. Carolyn Marie Wiese practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Carolyn Marie Wiese is 1235130576. The last update date is 2018-06-12.
Carolyn Marie Wiese's current location address is 2390 Mitchell Park Dr Ste D, Petoskey, Michigan. You can contact this provider via phone number 2314877200 and fax number 2314877188. The mailing address for Carolyn Marie Wiese is 2390 Mitchell Park Dr Ste D, Petoskey, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Carolyn Marie Wiese |
|---|---|
| Address | 2390 Mitchell Park Dr Ste D, Petoskey, Michigan |
| Phone Number | 2314877200 |
| Fax Number | 2314877188 |
| Sole Proprietor | N |
| Credentials | PA |
NPI Number Detail
| NPI Number | 1235130576 |
|---|---|
| Provider Enumeration Date | 2005-08-09 |
| Last Updated Date | 2018-06-12 |
Provider Mailing Address Detail
| Address | 2390 Mitchell Park Dr Ste D |
|---|---|
| City | Petoskey |
| State | Michigan (MI) |
| Post Code | 497708965 |
| Phone Number | 2314877200 |
| Fax Number | 2314877188 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 5601003704 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1235130576 | MI | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Carolyn Marie Wiese by the Centers for Medicare & Medicaid Services (CMS)?
The Carolyn Marie Wiese has been assigned the NPI (National Provider Identifier) 1235130576. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Where is the Carolyn Marie Wiese located?
The Carolyn Marie Wiese is located at 2390 Mitchell Park Dr Ste D, Petoskey, MI 497708965.
What is the Carolyn Marie Wiese's specialty and taxonomy code?
The Carolyn Marie Wiese's specialty is Physician Assistant, and the corresponding taxonomy code is 363A00000X.
When did the Carolyn Marie Wiese receive its 1235130576?
The Carolyn Marie Wiese was issued its 1235130576 on 2005-08-09, which is the date when the organization was assigned this unique identifier.
As of what date was the information regarding Carolyn Marie Wiese, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Carolyn Marie Wiese, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2018-06-12.