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Individual

JONATHAN A EISENGART

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1611 S GREEN RD, SUITE 306B, SOUTH EUCLID, OH 44121-4128
(216) 291-3550
(216) 291-4849
Mailing address
1611 S GREEN RD, SUITE 306B, SOUTH EUCLID, OH 44121-4128
(216) 291-3550
(216) 291-4849

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
35-085315
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000368344
ANTHEM ID#
OH
01
1193810001
DMERC MEDICARE
OH
05
2491754
OH
01
P00282497
RAILROAD MEDICARE
Enumeration date
08/24/2005
Last updated
11/07/2007
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