MICHAEL WIDJAJA

FRANKFORT, KY
NPI1184285249
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207R00000X Internal Medicine
(Licence: KY  56540)
Enumeration Date2019-06-27
Last Update Date2022-08-11
Business Address
MICHAEL WIDJAJA MD
299 KINGS DAUGHTERS DR
FRANKFORT, KY 40601-4186
Phone number: 502-875-5240
Mailing Address
MICHAEL WIDJAJA MD
2151 MEETING ST APT 12209
LEXINGTON, KY 40509-4662
Phone number: 347-749-8428