| Doctor Name: | DR. CARLOS A WIEGERING |
| NPI Number: | 1619974243 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | MD019247E |
| Business Practice Address: | 200 Hospital Dr Suite 3 Tyrone, PA - 166861825 |
| Business Phone Number: | 8146844472 |
| Business Fax Number: | 8146844780 |
| Mailing Address: | 200 Hospital Dr, Suite 3 TYRONE |
| State: | PA |
| Postal Code: | 166861825 |
| Phone Number: | 8146844472 |
| Fax Number: | 8146844780 |
| NPI Enumeration Date: | 06/28/2005 |
| NPI Last Update Date: | 02/24/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | MD019247E |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |