Organization
WILHELM TIETKE MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILHELM TIETKE MD (PHYSICIAN/OWNER)
(256) 880-9628
Entity
Organization
Contact information
Practice address
131 LONGWOOD DR SW, HUNTSVILLE, AL 35801-4522
(256) 880-9628
(256) 880-9629
Mailing address
131 LONGWOOD DR SW, HUNTSVILLE, AL 35801-4522
(256) 880-9628
(256) 880-9629
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
7067
AL
Other
Enumeration date
08/07/2012
Last updated
08/07/2012
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