Individual
ANDREW JIMERSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11811 SHAKER BLVD, STE. 330, CLEVELAND, OH 44120-1931
(216) 721-1805
(216) 721-4257
Mailing address
PO BOX 210146, SOUTH EUCLID, OH 44121-7146
(216) 721-1805
(216) 721-4257
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
35-141190J
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000135949
ANTHEM
OH
05
—
2183622
—
OH
Enumeration date
07/08/2005
Last updated
07/08/2007
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