Individual
ANN K BUIKEMA WIARDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2251 DUBOIS DR, WARSAW, IN 46580-3212
(574) 269-2777
(574) 371-4697
Mailing address
2251 DUBOIS DR, WARSAW, IN 46580-3212
(574) 269-2777
(574) 371-4697
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
01047556A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01047556A
PHYSICIAN LICENSE
IN
05
—
200358390
—
IL
Enumeration date
12/23/2005
Last updated
06/12/2012
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