MEDICARE: DR. DENNIS J WIWI M.D.

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	35147310	OH

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	160039066	OTHER	OH	MEDICARE RAILROAD

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	311575051033	OTHER	OH	CARESOURCE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	000000021064	OTHER	OH	ANTHEM
7	990479	OTHER	OH	AETNA
8	0720620	OTHER	OH	UNITED HEALTHCARE
9	288098	OTHER	OH	AMERIGROUP

NPI Number	:	1093718306
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENNIS J WIWI M.D.

Provider Business Mailing Address
First Line	:	2060 READING RD
Second Line	:	SUITE 150
City	:	CINCINNATI
State	:	OH
Zip	:	45202-1454
Country	:	US
Telephone Number	:	513-721-3200
Fax Number	:	513-639-3186

Provider Business Practice Location Address
First Line	:	3301 MERCY HEALTH BLVD
Second Line	:	SUITE 215
City	:	CINCINNATI
State	:	OH
Zip	:	45211-1104
Country	:	US
Telephone Number	:	513-481-5100
Fax Number	:	513-481-3880

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

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	07/31/2015

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

Practice Phone: 513-481-5100
Practice Fax: 513-481-3880

3301 MERCY HEALTH BLVD , SUITE 525
CINCINNATI, OH
45211-1104