MEDICARE: DR. ALAN CECIL WINE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician	35-032845	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558325647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALAN CECIL WINE M.D.

Provider Business Mailing Address
First Line	:	3619 PARK EAST DR
Second Line	:	SUITE 211 SOUTH
City	:	CLEVELAND
State	:	OH
Zip	:	44122-4330
Country	:	US
Telephone Number	:	216-378-0900
Fax Number	:	216-378-1853

Provider Business Practice Location Address
First Line	:	3619 PARK EAST DR
Second Line	:	SUITE 211 SOUTH
City	:	CLEVELAND
State	:	OH
Zip	:	44122-4330
Country	:	US
Telephone Number	:	216-378-0900
Fax Number	:	216-378-1853

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2006
Last Update Date	:	07/08/2007

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