Individual provider · Type 1 NPI

Richard Lee Wiesemann Ii

Medical Physician Assistant · Coeur D Alene, ID

NPI number 1629220488 Active

Practice location

980 W Ironwood Dr Ste 104
Coeur D Alene, ID 83814-2668

Call (208) 667-0621 Map

Mailing address

1555 Liberty Ln Ste C
Missoula, MT 59808-2001

Other practice locations

  • 700 W Ironwood Dr Ste 120, Coeur D Alene, ID 83814-4405 · (208) 625-3640

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA-2733 (ID)
Physician Assistant 363A00000XMT 543 (MT)

Medical Physician Assistant: Definition to come...

4 other providers at this address

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About NPI 1629220488

Richard Lee Wiesemann Ii's National Provider Identifier is 1629220488, issued on Oct 10, 2008. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Coeur D Alene, ID. The record was last updated on Apr 7, 2026.