Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Lakewood Hospital Professional Services

Organization Family Medicine Physician · NPI 1386699106

Lakewood Hospital Professional Services provides Family Medicine Physician services in Lakewood, Ohio. Registered with an NPI since 2006.

In the registry since
2006

Practice location Address checks out

14600 Detroit Ave Ste 103
Lakewood, OH 44107-4207
Phone: (216) 227-0717
Fax: (216) 227-0827
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1386699106
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mark Wiedt — Chief Executive Officer · (440) 895-5021
NPI enumeratedMay 23, 2006
Last updated in NPPESAugust 22, 2020
Mailing address20525 Center Ridge Rd, Suite 220, Rocky River, OH 44116-3437

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