Individual
DR. RICHARD J WYDERSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1345 36TH ST STE B, VERO BEACH, FL 32960-4811
(772) 742-3799
(772) 742-3797
Mailing address
1345 36TH ST STE B, VERO BEACH, FL 32960-4811
(772) 742-3799
(772) 742-3797
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
2011-00791
NC
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
35-05-5443
OH
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
ME142917
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0800253
—
OH
Enumeration date
08/01/2006
Last updated
09/27/2022
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