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Individual

DR. MICHAEL SULLIVAN WIEDERHOLD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D., M.P.H., M.S.

Contact information

Practice address
900 HOPE WAY, ALTAMONTE SPRINGS, FL 32714-1502
(407) 357-1000
Mailing address
900 HOPE WAY, ALTAMONTE SPRINGS, FL 32714-1502
(407) 357-1000

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
E-6152
AR
208000000X
Pediatrics Physician
Primary
ME0111708
FL

Other

Enumeration date
04/26/2007
Last updated
04/28/2016
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