Provider Demographics
NPI:1093718306
Name:WIWI, DENNIS J (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:J
Last Name:WIWI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2060 READING RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202-1454
Mailing Address - Country:US
Mailing Address - Phone:513-721-3200
Mailing Address - Fax:513-639-3186
Practice Address - Street 1:3301 MERCY HEALTH BLVD
Practice Address - Street 2:SUITE 215
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-1104
Practice Address - Country:US
Practice Address - Phone:513-481-5100
Practice Address - Fax:513-481-3880
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35147310207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH160039066OtherMEDICARE RAILROAD
IN200072950Medicaid
OH311575051033OtherCARESOURCE
KY64961857Medicaid
OH0554403Medicaid
OH000000021064OtherANTHEM
OH990479OtherAETNA
OH0720620OtherUNITED HEALTHCARE
OH288098OtherAMERIGROUP
OH0554403Medicaid
OH288098OtherAMERIGROUP
OH311575051033OtherCARESOURCE
OH990479OtherAETNA