Provider Demographics
NPI:1538428859
Name:WEGNER, ADAM MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:MICHAEL
Last Name:WEGNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4601 PARK RD STE 300
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-2290
Mailing Address - Country:US
Mailing Address - Phone:336-659-3700
Mailing Address - Fax:
Practice Address - Street 1:1635 N GEORGE MASON DRIVE
Practice Address - Street 2:SUITE 310
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3616
Practice Address - Country:US
Practice Address - Phone:703-810-5215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-07
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2019-01728207X00000X
VA0101276301207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery