THOMAS RUSSELL WIETERS, M.D., P.A. (NPI# 1518149350) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518149350 |
| Entity Type | Organization |
| Organization Name | THOMAS RUSSELL WIETERS, M.D., P.A. |
| Other Organization Name | THE VEIN CENTER |
| Practice Address |
3070 Highway 17 N Suite 202 Mount Pleasant SC 29466-9300 |
| Practice Telephone | 8438818346 |
| Practice Fax Number | 8432844093 |
| Mailing Telephone | 8438818346 |
| Mailing Fax Number | 8432844093 |
| Enumeration Date | 2007-12-04 |
| Last Update Date | 2008-03-19 |
| Authorized Official Name | DR. THOMAS RUSSELL WIETERS (OWNER) |
| Authorized Official Telephone | 8438818346 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
10486 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 104862 | 05 |
| Other Name | Type Code |
|---|---|
| The Vein Center | Doing Business As Name - Organization |
| Street Address |
3070 HIGHWAY 17 N SUITE 202 |
| City | MOUNT PLEASANT |
| State | SC |
| Zip Code | 29466-9300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720689276 | Sweetgrass Pharmacy Carolina Park, LLC | Pharmacy | 3485 Park Avenue Blvd, Mount Pleasant, SC 29466 | 2020-11-02 |
| 1942836754 | Southern Grace Pain & Regenerative Medicine | Clinic/Center | 3520 Park Avenue Blvd., Suite 105, Mount Pleasant, SC 29466 | 2020-03-13 |
| 1174175038 | South Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 225 Faison Rd, Mount Pleasant, SC 29466 | 2019-07-11 |
| 1780246553 | Stacy Nicole Sherbutt | Dental Hygienist | Naval Weapons Statiom, 316 Red Bank Rd, Goose Creek, SC 29466 | 2019-07-02 |
| 1144780909 | Chantal Pilar Debreceny | Nurse Practitioner | 1167 Basketweave Drive, #204, Mount Pleasant, SC 29466 | 2019-03-20 |
| 1609364835 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 3525 Park Ave Blvd., Mount Pleasant, SC 29466 | 2018-04-24 |
| 1528561453 | Sea Island Medical Care | Clinic/Center | 2114 Highway 41, Suite 105, Mount Pleasant, SC 29466 | 2018-03-16 |
| 1992217707 | Kristina Estelle Johnson | Family Medicine | 2662, Lohr Dr, Mount Pleasant, SC 29466 | 2017-11-02 |
| 1801324181 | Collin T Weyer | Physical Therapist | 3301 Stockdale Street, Suite B, Mt. Pleasant, SC 29466 | 2017-05-31 |
| 1023467479 | Mariesa Eikevik | Physical Therapist | 3559 Franklin Tower Dr, Mount Pleasant, SC 29466 | 2016-06-07 |
| Find all providers in zip 29466 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043766017 | Charleston Vascular Surgery, P.C. | Surgery | 1280 Hospital Drive, Suite 302, Charleston Vascular Surgery, P.C., Mount Pleasant, SC 29464-1901 | 2016-08-30 |
| 1114174125 | Jonathan Kittredge | Surgery | 1280 Hospital Dr Unit 302, Mount Pleasant, SC 29464-1901 | 2008-08-20 |
| 1740379916 | Edward C. Morrison | Surgery | 851 Leonard Fulghum Dr Ste 100, Mount Pleasant, SC 29464-3793 | 2006-10-12 |
| 1255368106 | Thomas R Wieters | Surgery | 3070 N Highway 17, Suite 202, Mount Pleasant, SC 29466-9300 | 2006-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740840024 | Tyler Buckley | Surgery | 169 Ashley Ave, Room 202 Main Hospital, Msc333, Charleston, SC 29425 | 2019-06-18 |
| 1104237338 | William Jackson | Surgery | 101 S Ravenel St Ste 230, Florence, SC 29506-2624 | 2014-05-09 |
| 1962765081 | Goatee Vascular LLC | Surgery | 4036 River Oaks Dr, Unit B2, Myrtle Beach, SC 29579-6695 | 2012-06-22 |
| 1801985007 | Thomas C. Appleby | Surgery | 1327 Ashley River Road, Building B, Charleston, SC 29407 | 2006-10-12 |
| 1962519546 | Mary Black Health System LLC | Surgery | 1690 Skylyn Dr Ste 350, Spartanburg, SC 29307-1039 | 2006-08-23 |
| 1164536215 | Sean J Hislop | Surgery | 1327 Ashley River Rd, Charleston, SC 29407-5384 | 2006-08-18 |
| 1881600963 | Louis F Knoepp IIi | Surgery | 100 Health Way, Suite 1240, Anderson, SC 29621-7917 | 2006-07-31 |
| 1659321115 | Robert C. Allen | Surgery | 197 Piedmont Blvd Ste 100, Rock Hill, SC 29732-1824 | 2006-05-12 |
| 1164496527 | The Regional Medical Center of Orangeburg and Calhoun Counties | Surgery | 1175 Cook Rd Ste 320, Orangeburg, SC 29118-8247 | 2006-02-14 |
| 1063499226 | Newberry Surgical Associates Pa | Surgery | 2541 Evans Street, Suite 100, Newberry, SC 29108 | 2005-12-29 |
| Find all providers with the same taxonomy | ||||
| City | MOUNT PLEASANT |
| Zip Code | 29466 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.