Tyler J. Wiedeman

NPI #1861976037 in Lima, Ohio

Provider Information

NPI Number: 1861976037
Entity Type: Individual
Name: Tyler J. Wiedeman
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Enumeration Date: Sep 24, 2018
Last Updated: Sep 24, 2018

Practice Location

Address: 770 W HIGH ST STE 460
City: Lima
State: Ohio
ZIP Code: 45801-5908
Phone: (419) 226-4300

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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