Individual
DR. ROBERT EUGENE REARDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D
Contact information
Practice address
18901 LAKE SHORE BLVD, EUCLID, OH 44119-1078
(216) 531-9000
(216) 274-9629
Mailing address
18901 LAKE SHORE BLVD, EUCLID, OH 44119-1078
(216) 531-9000
(216) 274-9629
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
5001
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000123581
ANTHEM BLUE SHIELD
OH
05
—
0233198
—
OH
01
—
1535088
UMWA
OH
01
—
352766
STAYWELL HEALTH/WELLCARE
OH
Enumeration date
12/22/2005
Last updated
12/03/2007
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