Individual
MAE EDDIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(888) 501-1806
Mailing address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
50.008560RX
OH
Other
Enumeration date
02/06/2024
Last updated
02/06/2024
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