| Cheryl A Wesen, MD | |
| 19229 Mack Ave, Ste 34, Grosse Pointe Woods, MI 48236-2858 | |
| (313) 647-3912 | |
| (313) 347-3902 | 
| Full Name | Cheryl A Wesen | 
|---|---|
| Gender | Female | 
| Speciality | Surgery | 
| Location | 19229 Mack Ave, Grosse Pointe Woods, Michigan | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1255319729 | NPI | - | NPPES | 
| 3475787 | Medicaid | MI | |
| 4816915 | Medicaid | MI | |
| 0H231320 | Other | MI | BLUE CROSS GROUP | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 208600000X | Surgery | 4301062525 (Michigan) | Primary | 
| 2086X0206X | Surgery - Surgical Oncology | 4301062525 (Michigan) | Secondary | 
| Entity Name | Ascension Medical Group Michigan | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1114133485 PECOS PAC ID: 0648180406 Enrollment ID: O20081015000289 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Cheryl A Wesen, MD 19229 Mack Ave, Ste 34, Grosse Pointe Woods, MI 48236-2858 Ph: (313) 647-3912 | Cheryl A Wesen, MD 19229 Mack Ave, Ste 34, Grosse Pointe Woods, MI 48236-2858 Ph: (313) 647-3912 | 
| Dr. Richard Nazih Berri, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 19229 Mack Ave Ste 23, Grosse Pointe Woods, MI 48236 Phone: 313-647-3252 | |
| Dr. Jeffrey Scott Falk, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 19229 Mack Ave, Suite 34, Grosse Pointe Woods, MI 48236 Phone: 313-647-3900 Fax: 313-647-3902 |