| Wildwood Internal Medicine, Pc | |
|
16759 Main Street Suite 203 Wildwood MO 63040 | |
| (636) 458-4800 | |
| (636) 594-7500 |
| Full Name | Wildwood Internal Medicine, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 16759 Main Street, Wildwood, Missouri |
| Authorized Official Name and Position | John Wiedner (PRESENT) |
| Authorized Official Contact | 6364584800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wildwood Internal Medicine, Pc 16759 Main Street Suite 203 Wildwood MO 63040 Ph: (636) 458-4800 | Wildwood Internal Medicine, Pc 16759 Main Street Suite 203 Wildwood MO 63040 Ph: (636) 458-4800 |
| NPI Number | 1871726067 |
|---|---|
| Provider Enumeration Date | 09/03/2009 |
| Last Update Date | 09/03/2009 |
| Medicare PECOS PAC ID | 0547315822 |
|---|---|
| Medicare Enrollment ID | O20090910000352 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871726067 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | John F Wiedner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639151244 PECOS PAC ID: 3779673496 Enrollment ID: I20071219000230 |
Mercy Clinic East Communities Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 16555 Manchester Rd Ste 110, Wildwood, MO 63040 Phone: 636-405-3155 Fax: 636-405-3162 | |
Idim Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1909 Larimer Trl, Wildwood, MO 63011 Phone: 636-273-5311 |