Provider Demographics
NPI:1023037496
Name:WILBER, ROGER G (MD)
Entity Type:Individual
Prefix:
First Name:ROGER
Middle Name:G
Last Name:WILBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 METROHEALTH DR
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44109-1900
Mailing Address - Country:US
Mailing Address - Phone:216-778-7800
Mailing Address - Fax:
Practice Address - Street 1:2500 METROHEALTH DR
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44109-1900
Practice Address - Country:US
Practice Address - Phone:216-778-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-054280207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000212967OtherUNISON
000000503681OtherANTHEM
OHP00372969OtherRAILROAD MEDICARE
OH0315564Medicaid
OH738115OtherBUCKEYE
OHP00011019OtherRAILROAD MEDICARE
OH0658824OtherAETNA
OH364134OtherWELLCARE
OH0315564Medicaid
OH0658824OtherAETNA
OH000000212967OtherUNISON