Organization
PREMIER COMPREHENSIVE MANAGEMENT SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK E WIEDT (CHIEF EXECUTIVE OFFICER)
(440) 895-5056
Entity
Organization
Contact information
Practice address
20525 CENTER RIDGE RD, SUITE 220, ROCKY RIVER, OH 44116-3437
(440) 895-5056
(440) 333-2935
Mailing address
PO BOX 74169, CLEVELAND, OH 44194-4169
(440) 895-5056
(440) 333-2935
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2916152
—
OH
Enumeration date
11/01/2007
Last updated
02/16/2010
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