Individual
CHERYL A WESEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
19229 MACK AVE, STE 34, GROSSE POINTE WOODS, MI 48236-2858
(313) 647-3912
(313) 347-3902
Mailing address
19229 MACK AVE, STE 34, GROSSE POINTE WOODS, MI 48236-2858
(313) 647-3912
(313) 647-3902
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301062525
MI
2086X0206X
Surgical Oncology Physician
4301062525
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0H231320
BLUE CROSS GROUP
MI
05
—
3475787
—
MI
05
—
4816915
—
MI
Enumeration date
01/05/2006
Last updated
02/03/2012
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