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AGNE PETROSIUTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-3345
(216) 844-5431
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
57009674
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0050408
OH
Enumeration date
06/13/2007
Last updated
11/09/2011
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