Individual
DR. JARED MICHAEL WIDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
GUTHRIE CORTLAND MEDICAL CENTER, 134 HOMER AVENUE, CORTLAND, NY 13045
(607) 756-3561
(607) 756-3562
Mailing address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
176591
NY
207RC0000X
Cardiovascular Disease Physician
Primary
MD034608
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010039991
—
VA
05
—
035391600
—
DC
05
—
403555100
—
MD
Enumeration date
06/02/2006
Last updated
04/13/2021
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