Provider Demographics
NPI:1952339202
Name:WEDIG, BARBARA M (MD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:M
Last Name:WEDIG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 THRUSH FIELD WAY
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-9526
Mailing Address - Country:US
Mailing Address - Phone:585-218-9158
Mailing Address - Fax:
Practice Address - Street 1:353 ISLAND COTTAGE RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14612-2349
Practice Address - Country:US
Practice Address - Phone:585-225-2610
Practice Address - Fax:585-581-1396
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225966208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4470726OtherAETNA
NY02370170Medicaid
NY7702368OtherCOMMERCIAL