Individual
MATTHEW K. LASHUTKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
18101 LORAIN AVENUE, CLEVELAND CLINIC-FAIRVIEW HOSPITAL, EMERGENCY SERVICES, CLEVELAND, OH 44111-5612
(216) 476-7312
Mailing address
18101 LORAIN AVENUE, CLEVELAND CLINIC-FAIRVIEW HOSPITAL, EMERGENCY SERVICES, CLEVELAND, OH 44111-5612
(216) 476-7312
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35078592L
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2325979
—
OH
01
—
942460636119
CARESOURCE
OH
01
—
P00194538
MEDICARE RR-GA
OH
Enumeration date
06/08/2006
Last updated
06/28/2018
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