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Individual

DR. ARI JAY WIESEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6770 MAYFIELD RD STE 415, MAYFIELD HTS, OH 44124-2299
(440) 461-2550
(440) 461-3497
Mailing address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001
(440) 461-2550
(440) 461-5319

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
35.099505
OH
207RG0100X
Gastroenterology Physician
D72366
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
440207300
MD
01
974421-01
CAREFIRST BC/BS
MD
01
S062-0432
CAREFIRST BC/BS - REGIONAL
MD
Enumeration date
05/13/2008
Last updated
06/27/2014
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