Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. ANTONIO JAMAAL WIDEMAN, PEER SPECIALIST
Active Sole ProprietorMR. ANTONIO JAMAAL WIDEMAN, PEER SPECIALIST is a Peer Specialist healthcare provider located in MATTAPAN, Massachusetts. NPI 1932835238 is currently active in the NPPES registry. Verify at CMS.
Peer Specialist · MATTAPAN, MA
Registration Details
- NPI Number
- 1932835238
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 28, 2022 (4.0847221684176 yrs)
- Last Updated
- Jul 28, 2022
- License
-
202222 (MA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
884 CUMMINS HWY APT 4MATTAPAN, MA, 021262043Browse MA providers · Browse ZIP 02126
- Phone
- 6176916034
- Primary Specialty
-
Peer Specialist
175T00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.