Individual
NIR ATLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001
(216) 445-5000
(216) 445-3692
Mailing address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001
(216) 445-5000
(216) 445-3692
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
35.151024
OH
Other
Enumeration date
06/30/2015
Last updated
08/06/2024
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