Individual
MARTIN F. WIECZOREK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-3941
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
35-059026
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000206549
UNISON
OH
01
—
000000509190
ANTHEM
OH
05
—
0767237
—
OH
01
—
364130
WELLCARE
OH
01
—
4324108
AETNA
OH
01
—
743420
BUCKEYE
OH
01
—
P00382863
RAILROAD MEDICARE
OH
Enumeration date
07/09/2006
Last updated
12/04/2020
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