Individual
ERIC L. MARDERSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(440) 684-5865
(440) 684-5952
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
35-088879
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000221050
UNISON
OH
01
—
000000524529
ANTHEM
—
05
—
2730398
—
OH
01
—
414685
WELLCARE
OH
01
—
750895
BUCKEYE
OH
01
—
9779061
AETNA
—
01
—
P00397851
RAILROAD MEDICARE
OH
Enumeration date
03/30/2007
Last updated
06/30/2011
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