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Individual

NATHAN TIEDEKEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
301 S 7TH AVE, SUITE 365, WEST READING, PA 19611-1410
(570) 624-4777
(570) 624-4778
Mailing address
48 TUNNEL RD, SUITE 203, POTTSVILLE, PA 17901-3875
(570) 624-4777
(570) 624-4778

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MT197680
PA

Other

Enumeration date
06/30/2010
Last updated
08/03/2016
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