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Individual

EDWARD F KIEGER II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6847 N CHESTNUT ST, RAVENNA, OH 44266-3929
(330) 297-0811
Mailing address
PO BOX 30716, CLEVELAND, OH 44130-0716
(440) 879-0081
(440) 879-0084

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
35-027083
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000142800
ANTHEM
OH
05
0087463
OH
Enumeration date
02/14/2006
Last updated
07/11/2007
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