Individual
JEFFREY M STOVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-7330
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714
(216) 383-6614
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CPA.10563-NA
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2963048
—
OH
01
—
P00771653
MEDICARE RAILROAD
OH
Enumeration date
03/12/2009
Last updated
03/31/2020
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