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Contact Information

TULLY WIEDMAN, MD
5724 SILVEYVILLE ROAD
DIXON, CA95620
 Phone: 707-689-6522
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for TULLY WIEDMAN · (Male)

NPI # 1285774182
Status Active
Credentials MD
Entity Individual
Enumeration date 02/08/2007
Last updated 10/21/2009 - About 17 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # C35371
  • CA Medicaid 00C353710
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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