Individual
JOHN S TIEDEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
459 LOCUST AVE, CHARLOTTESVILLE, VA 22902-4808
(434) 296-7733
Mailing address
311 10TH ST NE, CHARLOTTESVILLE, VA 22902-5316
(434) 296-7733
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0101243857
VA
Other
Enumeration date
05/02/2007
Last updated
07/02/2008
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