Individual
DR. SCOTT DAVID WIEDENMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
128 LAGOON FOREST DR, PONTE VEDRA BEACH, FL 32082-2122
(904) 273-9591
(904) 273-9591
Mailing address
128 LAGOON FOREST DR, PONTE VEDRA BEACH, FL 32082-2122
(904) 273-9591
(904) 273-9591
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME51674
FL
Other
Enumeration date
08/30/2006
Last updated
03/24/2012
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