Provider Demographics
NPI:1992199970
Name:WIER, GARRISON PATRICK (MD)
Entity Type:Individual
Prefix:
First Name:GARRISON
Middle Name:PATRICK
Last Name:WIER
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 1:601 HALTON RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-3403
Mailing Address - Country:US
Mailing Address - Phone:864-458-7956
Mailing Address - Fax:
Practice Address - Street 1:5 STEVENS ST STE 100
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4528
Practice Address - Country:US
Practice Address - Phone:864-250-6487
Practice Address - Fax:864-250-6475
Is Sole Proprietor?:No
Enumeration Date:2015-03-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60858876207W00000X
SC85097207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1992199970Medicaid