Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0102X | Surgical Critical Care | 34013975 | OH |
NPI | 1265851059 |
---|---|
Provider Name | Erich M. Wessel |
First Address | Columbus, OH 43202-1559 |
Second Address | Columbus, OH 43210-1257 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2014 |
Last Update Date | 16/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0409584 | (05) | OH |