Michael  R  Wiedmer    MD
Contract Details
Anniston Orthopaedics
Facility name
Provider ID
P000001861
NPI
1225027790
Tax ID
630585592
Effective Date
11/1/1996
Last Updated
10/9/2018
Direct Contract
Yes
Term Date
10/2/2018
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
731 Leighton Avenue Suite 300
Anniston, AL 36207
United States
County
Calhoun
Phone
2562364121 (Phone)
Billing Details
Address
P.O. Box 1765
Anniston, AL 36202
Billing Phone
2562364121
Specialty Type
Surgery, Orthopedic
Map
Address