Individual
DR. HAREENDRA G. ADHVARYU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14601 DETROIT AVE, SUITE 690, LAKEWOOD, OH 44107-4214
(216) 529-2359
(216) 529-2813
Mailing address
14601 DETROIT AVE, SUITE 690, LAKEWOOD, OH 44107-4214
(216) 529-2359
(216) 529-2813
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
35-039398A
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000509266
ANTHEM BC/BS
OH
05
—
0398109
—
OH
01
—
341542312150
CARESOURCE
OH
01
—
350064
WELLCARE
OH
Enumeration date
06/19/2006
Last updated
02/06/2010
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