Healthcare Provider Details

I. General information

NPI: 1093718306
Provider Name (Legal Business Name): DENNIS J WIWI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2005
Last Update Date: 07/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 MERCY HEALTH BLVD SUITE 215
CINCINNATI OH
45211-1104
US

IV. Provider business mailing address

2060 READING RD SUITE 150
CINCINNATI OH
45202-1454
US

V. Phone/Fax

Practice location:
  • Phone: 513-481-5100
  • Fax: 513-481-3880
Mailing address:
  • Phone: 513-721-3200
  • Fax: 513-639-3186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number35147310
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: