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Individual
MARK L MIEDEMA
Active
Individual
MARK L MIEDEMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
13487
FL
208100000X
Physical Medicine & Rehabilitation Physician
E-9691
AR
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
49437
CO
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
E-9691
AR
Other
Enumeration date
06/17/2009
Last updated
03/19/2025
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