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Individual

DR. MATTHEW CHARLES WIDEMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DNP, RN, AGNP-C

Contact information

Practice address
1727 W BLUEWATER HWY, IONIA, MI 48846-8647
(616) 527-2510
Mailing address
1727 W BLUEWATER HWY, IONIA, MI 48846-8647
(616) 460-0071

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704287664NSA2001O
MI

Other

Enumeration date
04/09/2020
Last updated
04/09/2020
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