Organization
SUBURBAN HEMATOLOGY ONCOLOGY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALAN WINE M.D. (OWNER)
(216) 378-0900
Entity
Organization
Contact information
Practice address
3619 PARK EAST DR, SUITE 211, BEACHWOOD, OH 44122-4330
(216) 378-0900
(216) 378-1853
Mailing address
6463 TAYLOR MILL RD, INDEPENDENCE, KY 41051-9392
(859) 363-4900
(859) 363-4986
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
WI032845
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0304585
—
OH
Enumeration date
05/10/2007
Last updated
10/25/2007
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