Provider Demographics
NPI:1225327232
Name:WIEGHARD, NICOLE ELIZABETH KIEFER (MD)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:ELIZABETH KIEFER
Last Name:WIEGHARD
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 91734
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23291-1734
Mailing Address - Country:US
Mailing Address - Phone:804-358-6100
Mailing Address - Fax:804-342-7619
Practice Address - Street 1:9109 STONY POINT DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-1979
Practice Address - Country:US
Practice Address - Phone:804-327-8001
Practice Address - Fax:804-327-8002
Is Sole Proprietor?:No
Enumeration Date:2011-03-30
Last Update Date:2018-10-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101264800208600000X
LA305216208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery