Individual
EVA R JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-7700
(216) 286-6341
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35-082544
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000221240
UNISON
OH
01
—
000000344093
ANTHEM
OH
01
—
000000529688
ANTHEM
OH
05
—
1017666340001
—
PA
01
—
2439605
BCMH
OH
05
—
2439605
—
OH
01
—
363674
WELLCARE
OH
01
—
738065
BUCKEYE
OH
01
—
7617497
AETNA
OH
Enumeration date
07/21/2006
Last updated
12/17/2020
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