Individual
DR. JENNIFER MARIE HARGRAVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
9500 EUCLID AVE, J4-331, CLEVELAND, OH 44195-0001
(216) 444-4100
Mailing address
1500 DETROIT AVE, APT 508, CLEVELAND, OH 44113-2444
(660) 221-2843
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
2005017745
MO
207L00000X
Anesthesiology Physician
Primary
34.009886
OH
207P00000X
Emergency Medicine Physician
2005017745
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00616736
RR MEDICARE
MO
Enumeration date
08/23/2007
Last updated
02/02/2013
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