Individual
JAMES STUART TIEDEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
17 N MEDICAL PARK DR, FISHERSVILLE, VA 22939-2344
(540) 213-7720
Mailing address
17 N MEDICAL PARK DR, FISHERSVILLE, VA 22939-2344
(540) 213-7720
(540) 213-7481
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
0101048613
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006324321
—
VA
Enumeration date
11/07/2006
Last updated
07/08/2020
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