Individual
ROBERT WIEDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
150 BERGEN ST, D-GREEN, NEWARK, NJ 07103-2496
(973) 972-5108
(973) 972-8390
Mailing address
30 BERGEN ST, ADMC 12 1205, NEWARK, NJ 07107-3000
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
25MA06022600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6074006
—
NJ
Enumeration date
11/06/2006
Last updated
07/15/2009
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