Provider Demographics
NPI:1528027380
Name:VIEWEG, JOHANNES W (MD)
Entity Type:Individual
Prefix:
First Name:JOHANNES
Middle Name:W
Last Name:VIEWEG
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 918025
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-8025
Mailing Address - Country:US
Mailing Address - Phone:352-273-6815
Mailing Address - Fax:352-392-8846
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3003
Practice Address - Country:US
Practice Address - Phone:352-273-6815
Practice Address - Fax:352-392-8846
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC97-01184208800000X
FLME97192208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8912103Medicaid
FL276903400Medicaid
FLAA084ZMedicare PIN
G92661Medicare UPIN
NCG92661Medicare UPIN