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1275643223
SANDRA WIEDERHOLD
PORTAGE, MI
NPI
1275643223
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
208000000X Pediatrics
(Licence: MI 4301050967)
Enumeration Date
2006-08-30
Last Update Date
2018-10-09
Business Address
SANDRA WIEDERHOLD MD
670 MALL DR
PORTAGE, MI 49024-2878
Phone number: 269-327-1900
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Mailing Address
SANDRA WIEDERHOLD MD
1000 OAKLAND DR
KALAMAZOO, MI 49008-1282
Phone number:
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