Provider Demographics
NPI:1427084557
Name:WIGERT, ULRIKA M (MD)
Entity type:Individual
Prefix:DR
First Name:ULRIKA
Middle Name:M
Last Name:WIGERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 ELM ST N
Mailing Address - Street 2:CENTRACARE HEALTH SYSTEM - SAUK CENTRE
Mailing Address - City:SAUK CENTRE
Mailing Address - State:MN
Mailing Address - Zip Code:56378-1010
Mailing Address - Country:US
Mailing Address - Phone:320-352-6591
Mailing Address - Fax:320-352-5164
Practice Address - Street 1:425 ELM ST N
Practice Address - Street 2:CENTRACARE HEALTH SYSTEM - SAUK CENTRE
Practice Address - City:SAUK CENTRE
Practice Address - State:MN
Practice Address - Zip Code:56378-1010
Practice Address - Country:US
Practice Address - Phone:320-352-6591
Practice Address - Fax:320-352-5164
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2013-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN43086207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNN003453OtherCHAMPUS
GA080185615OtherRAILROAD MEDICARE
MN080958600Medicaid
MN356S3WIOtherBCBS
MN356S3WIOtherBCBS
GA080185615OtherRAILROAD MEDICARE
MN356S3WIMedicare PIN