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Todd M Wiese

  • Male

Medical Specialty

Professional ID

  • NPI: 1851721013
  • PECOS ID: 1153544317
  • Enrollment ID: I20150702000013
  • Credential(MD, DO, DPM):
  • Medical School:
  • Medical School Graduation Year: 2013

Hospital Service

  • Hospital CCN1: 460051
  • Business Name (LBN)1: Jordan Valley Medical Center
  • Hospital CCN2: 460009
  • Business Name (LBN)2: University Health Careuniv Hospitals And Clinics

Medical Practices

  • Organization Name: Alpine Anesthesia Llc
  • Group Practice ID assigned by PECOS: 0749501294
  • Number of Group Practice member: 19

Location

  • Address1: 3000 N Triumph Blvd
  • Address2:
  • City: Lehi
  • State: Utah
  • Zip Code: 84043
  • Phone Number: (801)636-6597

Medical Practices

  • Organization Name: University Of Utah Adult Services
  • Group Practice ID assigned by PECOS: 0941525273
  • Number of Group Practice member: 1169

Location

  • Address1: 50 N Medical Dr
  • Address2:
  • City: Salt Lake City
  • State: Utah
  • Zip Code: 84132
  • Phone Number: (801)581-8915

Medicare

  • Medicare Assignment: Yes
  • Report Quality of Care to Physician Quality Reporting System (PQRS):
  • Used Electronic health record (EHR):