ROBERT WIEDEMANN NPI 1093208118

NPI Information

NPI: 1093208118
Provider Name: ROBERT WIEDEMANN
Classification: Peer Specialist - 175T00000X
Entity Type: Individual
Address:
50430 SCHOOL HOUSE RD
CANTON, MI
ZIP 48187
Phone: (734) 495-1722
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Robert Wiedemann is a peer specialist in Canton, MI. The provider is individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. Robert Wiedemann NPI is 1093208118. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

50430 SCHOOL HOUSE RD
CANTON, MI
ZIP 48187-910
Phone: (734) 495-1722

The enumeration date for this NPI number is 6/13/2018 and was last updated on 6/16/2018.

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
1	175T00000X	Peer Specialist		N346195	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	213119549	MEDICAID	MICHIGAN

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

NPI Synchronization or Removal

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