Most Relevant Information
Provider Data
| NPI Number: | 1003465493 |
| Provider Name: | AMY WIESE |
| Entity Type: | Individual |
| Taxonomy Code: | 2082S0099X |
| Specialty: | Plastic Surgery |
| License Number: | 1144430133 |
Most Important Dates
| Enumeration Date: | 09/09/2019 |
| Last Updated: | 09/09/2019 |
Provider Practice Location
50 W BIG BEAVER RD STE 280
BLOOMFIELD HILLS
MI
483043912
Practice Location Phone/Fax
| Phone: | 2483223362 |
| Fax: |
Provider Mailing Location
7126 ARROWOOD DR
WEST BLOOMFIELD
MI
483242500
Provider Mailing Phone/Fax
| Phone: | 2488956278 |
| Fax: |