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NPI Code Detail

MEDICARE: MS. LEA MICHELE WOJTKIEWICZ PA

MEDICARE: MS. LEA MICHELE WOJTKIEWICZ PA
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
1363A00000XPhysician Assistant003562OH

General Provider Information

NPI Number : 1568716504
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LEA MICHELE WOJTKIEWICZ PA
Provider Business Mailing Address
First Line : 5800 COOPER FOSTER PARK RD W
Second Line :
City : LORAIN
State : OH
Zip : 44053-4131
Country : US
Telephone Number : 216-389-3400
Fax Number :
Provider Business Practice Location Address
First Line : 5800 COOPER FOSTER PARK RD W
Second Line :
City : LORAIN
State : OH
Zip : 44053-4131
Country : US
Telephone Number : 440-396-6874
Fax Number : 440-204-7815
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/29/2012
Last Update Date : 07/16/2019

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