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Individual

ANTHONY E BACEVICE JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1997 HEALTHWAY DR, SUITE 203, AVON, OH 44011-2834
(440) 988-6884
(440) 988-6896
Mailing address
24701 EUCLID AVE, THIRD FLOOR BILLING SERVICES, EUCLID, OH 44117-1714
(440) 988-6884
(440) 988-6896

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
35047772
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000324004
ANTHEM BC&BS
OH
05
0602806
OH
Enumeration date
05/09/2006
Last updated
06/17/2014
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