Organization
PSYCHIATRIC PHYSICIANS, PLLC
Active
Other names
James P. Wiaduck, M.D.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES PATRICK WIADUCK M.D. (MEDICAL DIRECTOR)
(231) 798-8337
Entity
Organization
Contact information
Practice address
4461 GRAND HAVEN ROAD, MUSKEGON, MI 49441
(231) 798-8337
(231) 798-9816
Mailing address
P.O. BOX 334, GRAND HAVEN, MI 49417
(231) 798-8337
(231) 798-9816
Taxonomy
Speciality
Code
Description
License number
State
2084P0015X
Psychosomatic Medicine Physician
4301066579
MI
2084P0800X
Psychiatry Physician
Primary
4301066579
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTANON10230
PTAN ON10230
MI
Enumeration date
04/26/2007
Last updated
01/08/2020
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