Search › Michigan › 2084V0102X
Brian Wideman, DO
NPI 1295364008 · on the registry since 2020
Practice
- Address
- 5333 Mcauley Dr
Suite 109
Ypsilanti, MI 48197 - Phone
- (734) 712-1400
- Fax
- (616) 267-7901
- Organisation at this address
- Donna J Tal Md Pc
Retinal Specialists Pc
Trinity Health-Michigan
St Joseph Mercy Hospital
St Joseph Mercy HospitalInferred from a shared address, not stated in the registry. - Clinicians at this address
- 480
Additional practice sites
- 2750 E Beltline Ave Ne, Grand Rapids, MI
Registry record
- Primary taxonomy
- 2084V0102X
2084V0102X
- Also registered as
- 2084N0400X
- Licence states on file
- MI
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2025-08-12
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan