is a Pediatric Emergency Medicine in Cleveland, Ohio. practices all healthcare services and medical treatments related to Pediatric Emergency Medicine. The NPI Number for is 1790897239. The last update date is .
's current location address is 11100 Euclid Ave, Cleveland, Ohio. You can contact this provider via phone number 2168447700 and fax number 2162866341. The mailing address for is 11100 Euclid Ave, Cleveland, Ohio. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 11100 Euclid Ave, Cleveland, Ohio |
| Phone Number | 2168447700 |
| Fax Number | 2162866341 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1790897239 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 11100 Euclid Ave |
|---|---|
| City | Cleveland |
| State | Ohio (OH) |
| Post Code | 441061716 |
| Phone Number | 2168447700 |
| Fax Number | 2162866341 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatric Emergency Medicine |
|---|---|
| Taxonomy | 2080P0204X |
| Licence No | 35-075781 |
|
Definition: A pediatrician who has special qualifications to manage emergencies in infants and children. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 183504 | OH | ANTHEM | |
| 2195342 | OH | -- | |
| 2195342 | OH | BCMH | |
| 363788 | OH | WELLCARE | |
| 221146 | OH | UNISON | |
| 745937 | OH | BUCKEYE | |
| 2356499 | OH | AETNA | |
| 526056 | OH | ANTHEM |
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