Wiechert, Mark A

Wiechert, Mark A is an individual health care provider with primary practice located at 1707 N Henderson St , Galesburg IL 61401-1320. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Wiechert, Mark A can be contacted via phone (309) 343-1000.

Contact Information

Primary practice address
1707 N Henderson St Galesburg IL 61401-1320
Phone: (309) 343-1000
Fax: (309) 344-1054
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X Illinois

Profile Details

NPI number 1063513893
LBN Legal business name Wiechert, Mark A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 26th, 2006
Last updated Jul 8th, 2007 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063513893 NPPES
Other 5471051 AETNA
Other 4815127 AETNA
Other 11054102 AETNA

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