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Organization

DIGESTIVE DISEASES CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RICHARD A WEDDLE MD (PRESIDENT)
(812) 331-0233
Entity
Organization

Contact information

Practice address
2920 MCINTYRE DR STE 310, BLOOMINGTON, IN 47403-4215
(812) 331-0233
(812) 331-0287
Mailing address
2920 S MCINTYRE DR STE 310, BLOOMINGTON, IN 47403-4215
(812) 331-0233
(812) 331-0287

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
01031299A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100184520
IN
05
200890860A
IN
Enumeration date
06/20/2007
Last updated
04/29/2008
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