Individual
STEVEN CARL BLAHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14519 DETROIT AVE, LAKEWOOD, OH 44107-4316
(216) 521-4200
Mailing address
33479 VINEYARD PARK, AVON, OH 44011-2580
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35070972
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0460184
—
OH
01
—
942460636112
CARESOURCE
OH
Enumeration date
05/28/2006
Last updated
07/08/2007
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