Individual
MR. ALBERT A ETHEART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA C
Contact information
Practice address
20300 CHARGRIN BLVD, SHAKER HEIGHTS, OH 44122-4412
(614) 505-7633
Mailing address
PO BOX 30790, MEDINA EMERGENCY ASSOCIATES LTD, MIDDLEBURG HEIGHTS, OH 44130-0790
(330) 654-1185
(330) 654-9086
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50001006
OH
Other
Enumeration date
11/11/2005
Last updated
05/03/2019
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