Stewart E Wiegand, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

012988 Issued in GA

Practice address

755 Mt Vernon Highway
Suite 110
Atlanta, GA 30328-4276

Phone

(404) 256-9692

Fax

(404) 256-9404

NPI assigned

Nov 2, 2005

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dermatology Affiliates, LLC

  • Specialist
  • Atlanta, GA
  • NPI 1730244872
  NPD (past)
• Wesley S Wilborn MD PC

  • Dermatology Physician
  • Atlanta, GA
  • NPI 1750554978
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396915200000",
    "number": "1477544138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 S MAIN ST",
            "address_2": "SUITE A2",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300091974",
            "telephone_number": "404-256-9692",
            "fax_number": "404-256-9404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 MT VERNON HIGHWAY",
            "address_2": "SUITE 110",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303284276",
            "telephone_number": "404-256-9692",
            "fax_number": "404-256-9404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEGAND",
        "first_name": "STEWART",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2014-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "012988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CM5399",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00176481C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joshua Widner
• Lucas Wieck
• Christine Patricia Wiedenhoft
• Max Alan Wieder
• Jacqueline Harper Wiederholt, RPH
• Kristen McLendon Wieler, RN, WHNP, CNP
• Nicole Lynne Wiesen, MSW
• Jacqueline Wieting, NP-BC
• Wig Medical LLC
• Hannah Wiggers

• Dermatology Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Dermatology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.