Organization
LAKEWOOD HOSPITAL PROFESSIONAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK E WIEDT (CHIEF EXECUTIVE OFFICER)
(440) 895-5021
Entity
Organization
Contact information
Practice address
1730 W 25TH ST, SUITE 1100, CLEVELAND, OH 44113-3108
(216) 771-4455
(216) 241-1569
Mailing address
20525 CENTER RIDGE RD, SUITE 220, ROCKY RIVER, OH 44116-3437
(440) 895-5021
(440) 895-5050
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
05/22/2006
Last updated
08/22/2020
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