Organization
ALL GOD'S CHILDREN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MONICA LYNN WEIDENHAMER M.D. (SOLE PROPRIETOR)
(724) 453-0568
Entity
Organization
Contact information
Practice address
626 W NEW CASTLE ST, ZELIENOPLE, PA 16063-2005
(724) 453-0568
Mailing address
626 W NEW CASTLE ST, ZELIENOPLE, PA 16063-2005
(724) 453-0568
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
MD038036E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012033300005
—
PA
01
—
993771
HIGHMARK BC BS
PA
Enumeration date
06/14/2007
Last updated
08/10/2007
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