| Doctor Name: | MARC F WUERDEMAN |
| NPI Number: | 1154617629 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 26858 |
| Business Practice Address: | 5005 N Piedras St Graduate Medical Education El Paso, TX - 799205001 |
| Business Phone Number: | 9157422521 |
| Business Fax Number: | 9157432653 |
| Mailing Address: | 9040 Fitzsimmons Dr, JOINT BASE LEWIS MCCHORD |
| State: | WA |
| Postal Code: | 984311000 |
| Phone Number: | 2539683400 |
| Fax Number: | |
| NPI Enumeration Date: | 06/23/2011 |
| NPI Last Update Date: | 03/09/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 26858 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NE |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |