Organization
FAIRVIEW HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANURADHA BAKSHI MD (RESIDENT)
(216) 476-7086
Entity
Organization
Contact information
Practice address
18200 LORAIN AVE, CLEVELAND, OH 44111-5605
(216) 476-7086
(216) 476-7604
Mailing address
18200 LORAIN AVE, CLEVELAND, OH 44111-5605
(216) 476-7086
(216) 476-7604
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
57011880
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57011880
TEMPORARY LICENSE #
OH
Enumeration date
05/01/2007
Last updated
08/22/2020
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