Individual
JOEL WIETFELDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2901 GREENBRIAR DR, SPRINGFIELD, IL 62704-6425
(217) 528-7541
Mailing address
1025 S 6TH ST, SPRINGFIELD, IL 62703-2403
(217) 528-7541
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
036129983
IL
Other
Enumeration date
05/03/2007
Last updated
05/19/2020
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