Individual
DR. GARY MASON WILKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
23811 CHAGRIN BLVD, STE 170, BEACHWOOD, OH 44122-5525
(216) 765-0440
(216) 765-0448
Mailing address
28249 SHAKER BLVD, PEPPER PIKE, OH 44124-5006
(216) 464-2795
(216) 765-0448
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
35049560
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0602486
—
OH
Enumeration date
06/21/2005
Last updated
10/08/2009
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