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Contact Information

NICOLAS A WIEDER, DO
750 TOWNPARK LANE
KAISER PERMANENTE TOWNPARK MEDICAL CENTER
KENNESAW, GA30144
 Phone: 818-375-2000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

208VP0000X 72 Physician/Pain Management
Indicates primary specialty

NPI Profile & details for NICOLAS A WIEDER · (Male)

NPI Number 1467500322
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 01/08/2007
Last updated 12/02/2016 - About 10 years ago
Sole proprietor 1 No
Identifiers
  • CA License # 20A5558
  • GA License # 075400
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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