Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. MARK DAVID WIGOD, MD
Active Sole ProprietorDR. MARK DAVID WIGOD, MD is a Plastic and Reconstructive Surgery healthcare provider located in MERIDIAN, Idaho. NPI 1427086164 is currently active in the NPPES registry. Verify at CMS.
Plastic and Reconstructive Surgery · MERIDIAN, ID
Registration Details
- NPI Number
- 1427086164
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 29, 2006 (20.137462819255 yrs)
- Last Updated
- Jul 8, 2007
- License
-
M8189 (ID)
- Sole Proprietor
- Yes
Practice Information
- Address
-
3630 E LOUISE DRIVEMERIDIAN, ID, 83642Browse ID providers · Browse ZIP 83642
- Phone
- 2083779515
- Fax
- 2083779517
- Primary Specialty
-
Plastic and Reconstructive Surgery
2086S0122X
Other Plastic and Reconstructive Surgery Providers in MERIDIAN, ID
| Name | Credential | NPI |
|---|---|---|
| REBECCA D SHAW | CFA | 1275772667 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.