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Individual

JOSEPH E WILLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-7494
(216) 383-6749
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714

Taxonomy

Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
35-064955
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000030263
ANTHEM
OH
01
000000224343
UNISON
OH
01
000000528785
ANTHEM
OH
05
0127311
OH
01
0127464
BCMH
OH
01
0661297
AETNA
OH
05
1265458509
MI
01
220017472
RAILROAD MEDICARE
OH
01
364137
WELLCARE
OH
01
751029
BUCKEYE
OH
01
P00420617
RAILROAD MEDICARE
OH
Enumeration date
07/13/2006
Last updated
07/22/2011
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