Individual
JOHN WIEDNER
Active
Individual
JOHN WIEDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R6G00
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000010043
ESSENCE
MS
01
—
0400320
UHC
MO
01
—
113996
HEALTHLINK
MO
01
—
127506
GHP
MO
01
—
16748
BCBS
MO
01
—
4104267
AETNA
MO
01
—
E10053
MERCY
MO
Enumeration date
11/18/2005
Last updated
05/02/2016
Update your record
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