Individual
MIRIAM WILDEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1 HOSPITAL DR FL 3, CHARLOTTESVILLE, VA 22908-2818
(434) 982-4403
(434) 924-0217
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
0101258500
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/28/2011
Last updated
08/23/2017
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