# MICHAEL ALAN WIEDEMANN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1306898002
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | MD017792 | LA | Yes |

## Other

- **Enumeration date:** 05/17/2006
- **Last updated:** 07/20/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 09459713 | — | MS |
| 05 | — | 1112151 | — | LA |
| 05 | — | 1380580 | — | LA |