| Scott L Wiesen Md Llc | |
|
625 Tamiami Trl N Suite 304 Naples FL 34102-8143 | |
| (239) 775-4444 | |
| (239) 775-4445 |
| Full Name | Scott L Wiesen Md Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 625 Tamiami Trl N, Naples, Florida |
| Authorized Official Name and Position | Scott L Wiesen (PRESIDENT) |
| Authorized Official Contact | 2397754444 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Scott L Wiesen Md Llc 625 9th St N Suite 304 Naples FL 34102-8143 Ph: (239) 775-4444 | Scott L Wiesen Md Llc 625 Tamiami Trl N Suite 304 Naples FL 34102-8143 Ph: (239) 775-4444 |
| NPI Number | 1235448184 |
|---|---|
| Provider Enumeration Date | 09/27/2010 |
| Last Update Date | 06/08/2012 |
| Medicare PECOS PAC ID | 9234324328 |
|---|---|
| Medicare Enrollment ID | O20101115001017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235448184 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | ME53124 (Florida) | Primary |
| Provider Name | Ashok Koul |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1982678041 PECOS PAC ID: 8729094412 Enrollment ID: I20060306000184 |
| Provider Name | Scott L Wiesen |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1831130814 PECOS PAC ID: 1052496502 Enrollment ID: I20100720000290 |
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