Provider Demographics
NPI:1417080763
Name:MIGGIANI, WOLFGANG PETER (MD)
Entity Type:Individual
Prefix:DR
First Name:WOLFGANG
Middle Name:PETER
Last Name:MIGGIANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1227
Mailing Address - Street 2:
Mailing Address - City:MCPHERSON
Mailing Address - State:KS
Mailing Address - Zip Code:67460-1227
Mailing Address - Country:US
Mailing Address - Phone:620-241-2251
Mailing Address - Fax:620-241-2139
Practice Address - Street 1:1000 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:MCPHERSON
Practice Address - State:KS
Practice Address - Zip Code:67460-2326
Practice Address - Country:US
Practice Address - Phone:620-241-2250
Practice Address - Fax:620-241-4342
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0427097207P00000X, 207Q00000X
OH35.132010207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100302530SMedicaid
KS100302530FMedicaid
KS1417080763OtherBLUE SHIELD
KSKA1000018Medicare PIN
KS100302530CMedicaid
KS100302530PMedicaid
KSKA1209015Medicare PIN
KSKA2922007Medicare PIN
KS100302530HMedicaid
KSP00668170Medicare PIN
055974MIMedicare ID - Type Unspecified
G62754Medicare UPIN