Individual
MICHAEL A DEGEORGIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 986-1256
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714
(216) 383-6950
(216) 383-6749
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
35077420D
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000225045
UNISON
OH
01
—
000000532719
ANTHEM
OH
05
—
1053425983
—
MI
05
—
2146252
—
OH
01
—
414959
WELLCARE MEDICAID
OH
01
—
7350024
AETNA
OH
01
—
737176
BUCKEYE MEDICAID
OH
01
—
P00440902
RAILRAOD MEDICARE
OH
Enumeration date
08/18/2006
Last updated
05/12/2014
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