Provider Demographics
NPI:1124560339
Name:WIERMAN, BENJAMIN (LMT)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:
Last Name:WIERMAN
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:BEN
Other - Middle Name:
Other - Last Name:WIERMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2469 STELZER RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-3129
Mailing Address - Country:US
Mailing Address - Phone:614-416-6200
Mailing Address - Fax:
Practice Address - Street 1:2469 STELZER RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-3129
Practice Address - Country:US
Practice Address - Phone:614-416-6200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-07
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program