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Individual

IVAN T CAKULEV

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-8500
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
35-081374
OH
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
35-081374
OH
207RC0001X
Clinical Cardiac Electrophysiology Physician
35.081374
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000224440
UNISON
01
000000539491
ANTHEM
05
2523111
OH
01
363391
WELLCARE
01
734681
BUCKEYE
01
7598674
AETNA
OH
01
P00226315
RAILROAD MEDICARE
OH
01
P00428927
RAILROAD MEDICARE
OH
Enumeration date
07/13/2006
Last updated
01/14/2021
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