Doctor Name: | DR. WILLIAM DONALD WIERMAN |
NPI Number: | 1699708834 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 26727 |
Business Practice Address: | 1008 Minnequa Ave Pueblo, CO - 810043733 |
Business Phone Number: | 7195605656 |
Business Fax Number: | 7195604715 |
Mailing Address: | 445 E Cheyenne Mountain Blvd Ste C Pmb 406, COLORADO SPRINGS |
State: | CO |
Postal Code: | 809064570 |
Phone Number: | 7195388100 |
Fax Number: | 7195388003 |
NPI Enumeration Date: | 07/09/2006 |
NPI Last Update Date: | 01/15/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 26727 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |