Individual
BEVERLY A WISDOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
10701 EAST BLVD, SUITE 1B 236, CLEVELAND, OH 44106-1702
(419) 215-3171
(216) 231-3411
Mailing address
10701 WADE PARK, SUITE 1-B 236, CLEVELAND, OH 44106-1702
(419) 215-3171
(216) 231-3411
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
50001450
OH
Other
Enumeration date
07/13/2005
Last updated
06/29/2020
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