Individual
JOSEPH P WIEDEMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1850 E PARK AVE, STATE COLLEGE, PA 16803-6706
(814) 235-2480
(814) 235-2482
Mailing address
PO BOX 858, MC A410, HERSHEY, PA 17033-0858
(800) 243-1455
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD065285L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7859104
—
NJ
Enumeration date
02/16/2006
Last updated
03/28/2018
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