Individual
DR. HARALD J.A. WIEDEMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
114 DEER RUN RD., KETCHUM, ID 83340-2290
(208) 726-5592
(208) 726-5592
Mailing address
PO BOX 2290, KETCHUM, ID 83340-2290
(208) 726-5592
(208) 726-5592
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
M-2626
ID
Other
Enumeration date
06/10/2009
Last updated
01/31/2014
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