Organization
WILDWOOD INTERNAL MEDICINE, PC
Active
Parent organization
WILDWOOD INTERNAL MEDICINE, PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
WILDWOOD INTERNAL MEDICINE, PC
Authorized official
JOHN WIEDNER M.D. (PRESENT)
(636) 458-4800
Entity
Organization
Contact information
Practice address
16759 MAIN STREET, SUITE 203, WILDWOOD, MO 63040
(636) 458-4800
(636) 594-7500
Mailing address
16759 MAIN STREET, SUITE 203, WILDWOOD, MO 63040
(636) 458-4800
(636) 594-7500
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
09/03/2009
Last updated
09/03/2009
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