Individual
DR. PAUL WEDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1025 PENNOCK PL, STE 121, FORT COLLINS, CO 80524-3257
(970) 624-4439
Mailing address
1025 PENNOCK PL, STE 121, FORT COLLINS, CO 80524-3257
(970) 624-4439
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036060589
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036060589
STATE LICENSE
IL
05
—
036060589
—
IL
Enumeration date
12/02/2005
Last updated
12/26/2014
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