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Individual

BAHMAN GUYURON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(440) 461-1617
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
35-043031
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000221048
UNISON
OH
01
000000503662
ANTHEM
OH
05
0474286
OH
01
363595
WELLCARE MEDICAID
OH
01
4224430
AETNA
OH
01
746000
BUCKEYE MEDICAID
OH
Enumeration date
07/14/2006
Last updated
07/14/2011
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