Wildwood Internal Medicine, PC

NPI #1871726067 in Wildwood, Missouri

Provider Information

NPI Number
1871726067
Entity Type
Organization
Organization Name
Wildwood Internal Medicine, PC
Subpart
Yes (part of a larger organization)
Parent Organization
WILDWOOD INTERNAL MEDICINE, PC
Primary Specialty
Internal Medicine
Enumeration Date
Sep 3, 2009
Last Updated
Sep 3, 2009

Practice Location

Address
16759 MAIN STREET
Address 2
SUITE 203
ZIP Code
63040
Phone
(636) 458-4800

Authorized Official

Name
JOHN WIEDNER, M.D.
Title
PRESENT
Phone
(636) 458-4800

Specialties & Taxonomy Codes

Specialty
Internal Medicine

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