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Individual

BAZ P DEBAZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
13207 RAVENNA RD, CHARDON, OH 44024-7032
(440) 285-6000
(216) 844-5922
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714
(440) 285-6000
(216) 844-5922

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
35-045896
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0491605
OH
05
1025763490001
PA
01
P00364273
RAILROAD MEDICARE
OH
Enumeration date
07/09/2006
Last updated
12/20/2011
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