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Individual

DEAN A NAKAMOTO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
10701 EAST BLVD, CLEVELAND, OH 44106-1702
(216) 791-3800
Mailing address
10701 EAST BLVD, CLEVELAND, OH 44106-1702

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
35-055716
OH
2085R0202X
Diagnostic Radiology Physician
35055716
OH
2085R0204X
Vascular & Interventional Radiology Physician
35-055716
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000209122
UNISON
OH
01
000000503572
ANTHEM
OH
01
0304914
BCMH
OH
05
0882120
OH
05
1012090040001
PA
01
363870
WELLCARE
OH
01
3810009944
WV MEDICAID
WV
01
4392730
AETNA
OH
01
732574
BUCKEYE
OH
01
P00364277
RAILROAD MEDICARE
OH
Enumeration date
07/10/2006
Last updated
10/24/2023
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