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WILDWOOD INTERNAL MEDICINE PC NPI 1871726067


NPI Information

NPI: 1871726067
Provider Name: WILDWOOD INTERNAL MEDICINE, PC
Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 26D0857265

Address:
16759 MAIN STREET
SUITE 203
WILDWOOD, MO
ZIP 63040
Phone: (636) 458-4800
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WILDWOOD INTERNAL MEDICINE, PC is an internal medicine in Wildwood, MO. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. WILDWOOD INTERNAL MEDICINE, PC NPI is 1871726067. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

16759 MAIN STREET
SUITE 203
WILDWOOD, MO
ZIP 63040
Phone: (636) 458-4800
Fax: (636) 594-7500

The provider's authorized official is John Wiedner .
The authorized official title is Present and has the following contact phone number (636) 458-4800.

The CLIA number assigned to this NPI record is 26D0857265 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/3/2009 and was last updated on 9/3/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207R00000XInternal MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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