MEDICARE: SARAH RENEE WIEDERHOLT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	T2004018057	MO
2	207Q00000X	Family Medicine Physician	2008003502	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00628597	OTHER	MO	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	39921013	OTHER	MO	BLUE CROSS BLUE SHIELD OF KANSAS CIITY

General Provider Information

NPI Number	:	1528161304
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH RENEE WIEDERHOLT MD

Provider Business Mailing Address
First Line	:	5210 NORTH BELT HIGHWAY
Second Line	:
City	:	ST JOSEPH
State	:	MO
Zip	:	64506-1211
Country	:	US
Telephone Number	:	816-271-4971
Fax Number	:	816-271-6010

Provider Business Practice Location Address
First Line	:	5210 NORTH BELT HIGHWAY
Second Line	:
City	:	ST JOSEPH
State	:	MO
Zip	:	64506-1211
Country	:	US
Telephone Number	:	816-271-4971
Fax Number	:	816-271-6010

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/06/2006
Last Update Date	:	11/22/2017

Similar Medicare Providers

1003882150 — DR. KAJAL DASGUPTA M.D.
Practice Location Address:

2101 E JEFFERSON ST , KAISER PERMANENTE MEDICARE ENROLLMENT
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-2424
Practice Fax:

1881646115 — MS. MELISSA RYAN STRAUSS P.A.
Practice Location Address:

2101 E JEFFERSON ST , KAISER PERMANENTE MEDICARE ENROLLMENT
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-2424
Practice Fax:

1497832083 — DR. LYSA CHARLES MD
Practice Location Address:

2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNT 6 WEST , KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-6660
Practice Fax: 301-816-6308

1447337068 — STEPHANIE GANSCHOW PHARMD
Practice Location Address:

2500 E 52ND ST N , CIGNA MEDICARE SERVICES
SIOUX FALLS, SD
57104-7106

Practice Phone: 605-373-0100
Practice Fax:

1184691321 — DAVID J. SCHOEBERL DC
Practice Location Address:

5210 N BELT HWY STE 100
SAINT JOSEPH, MO
64506-1211

Practice Phone: 816-271-8830
Practice Fax: 816-271-8831

1235161605 — DR. DAVIN G TURNER DO
Practice Location Address:

5210 N BELT HWY
SAINT JOSEPH, MO
64506-1211

Practice Phone: 816-271-1330
Practice Fax: 816-271-1333

1841218948 — JAMES G. DAY D.O.
Practice Location Address:

5210 N BELT HWY
SAINT JOSEPH, MO
64506-1211

Practice Phone: 816-271-4951
Practice Fax: 816-385-8905

Directions to “ SARAH RENEE WIEDERHOLT MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.