Organization
TODD M. WIEDEL, O.D., PA
Active
Other names
Crosslake Eye Center, Pequot Eye Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TODD M WIEDELL OD (DIRECTOR OF CORPORATION)
(218) 568-5555
Entity
Organization
Contact information
Practice address
30960 GOVERNMENT DR, PEQUOT LAKES, MN 56472-1003
(218) 568-5555
(218) 568-8904
Mailing address
PO BOX 176, PEQUOT LAKES, MN 56472-0176
(218) 568-5555
(218) 568-8904
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
332H00000X
Eyewear Supplier
2945
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
176684800
—
MN
01
—
1BI74PE
BCBS
MN
01
—
22-05547
MEDICA
MN
Enumeration date
12/18/2009
Last updated
10/10/2019
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us