Individual
SHILOH WEDERMYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
51467 IN-933, SOUTH BEND, IN 46637
(574) 243-0904
Mailing address
321 S MAIN ST APT 203, SOUTH BEND, IN 46601-2232
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
1-109618
KS
183500000X
Pharmacist
Primary
26028410A
IN
Other
Enumeration date
12/14/2020
Last updated
12/19/2020
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