Individual
APRA SOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001
(216) 444-5725
Mailing address
6000 W CREEK RD, SUITE 10, INDEPENDENCE, OH 44131-2139
(216) 444-5725
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
35089630
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2758047
—
OH
Enumeration date
09/13/2007
Last updated
10/18/2007
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