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Individual

MICHAEL W KONSTAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-7700
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714

Taxonomy

Speciality
Code
Description
License number
State
2080P0214X
Pediatric Pulmonology Physician
Primary
35-047897
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000028203
ANTHEM
OH
01
000000221262
UNISON
OH
01
000000526037
ANTHEM
OH
05
0011302060005
PA
05
0699829
OH
05
1568482537
MI
01
363717
WELLCARE
OH
01
642954
AETNA
OH
01
699829
BCMH
OH
01
745931
BUCKEYE
OH
Enumeration date
07/20/2006
Last updated
11/17/2010
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