Individual
ERWIN WIETRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6147 STATE ROUTE 122 STE 200, MIDDLETOWN, OH 45005-5201
(513) 261-3500
(513) 261-3509
Mailing address
1 PRESTIGE PL STE 550, MIAMISBURG, OH 45342-6115
(937) 762-1310
(937) 522-8068
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
06262
KY
207Q00000X
Family Medicine Physician
34.017377
OH
207Q00000X
Family Medicine Physician
Primary
TP719
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/31/2020
Last updated
01/30/2026
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