Provider Demographics
NPI:1851485023
Name:WERTMAN, JAMES MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MICHAEL
Last Name:WERTMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:J.
Other - Middle Name:MICHAEL
Other - Last Name:WERTMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1001 LAKESIDE AVE E
Mailing Address - Street 2:#1200
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44114-1158
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17406 ROYALTON RD
Practice Address - Street 2:
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-5151
Practice Address - Country:US
Practice Address - Phone:216-524-7377
Practice Address - Fax:440-846-2832
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2013-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-069725208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0233081Medicaid
OH0233081Medicaid
WE0799323Medicare ID - Type Unspecified