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Individual

AARON PROWELLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
11100 EUCLID AVENUE, CLEVELAND, OH 44106
(215) 823-5800
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD071137L
PA
207RC0000X
Cardiovascular Disease Physician
MD071137L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000233297
UNISON
OH
01
000000552368
ANTHEM
OH
05
2790485
OH
01
9064121
AETNA
OH
Enumeration date
09/27/2006
Last updated
12/07/2020
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