Healthcare Provider Details

I. General information

NPI: 1992918593
Provider Name (Legal Business Name): CHARLES R. WEHBE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 03/24/2023
Certification Date: 03/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 KOLBE RD STE 227
LORAIN OH
44053-1601
US

IV. Provider business mailing address

3600 KOLBE RD STE 227
LORAIN OH
44053-1601
US

V. Phone/Fax

Practice location:
  • Phone: 440-960-4512
  • Fax: 440-960-4513
Mailing address:
  • Phone: 440-960-4512
  • Fax: 440-960-4513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number35.099586
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: