Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 245047 | MA |
N | 207VX0201X | Gynecologic Oncologist | 19334 | NH |
Y | 207VX0201X | Gynecologic Oncologist | 245047 | MA |
NPI | 1235455684 |
---|---|
Provider Name | Dr. Andrew Christopher Wiechert |
First Address | Burlington, MA 01805-0001 |
Second Address | Boston, MA 02115-6110 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2010 |
Last Update Date | 22/05/2019 |