Individual
JEFFERY WIELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
325 CENTER ST, STE 1, CHARDON, OH 44024
(440) 285-2666
Mailing address
PO BOX 483, CHARDON, OH 44024-0483
(440) 285-2666
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
36-00-3359
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2426682
—
OH
Enumeration date
06/21/2005
Last updated
01/28/2013
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