Individual
DR. EDWIN G AVERY IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-7334
(216) 844-3781
Mailing address
3605 WARRENSVILLE CENTER RD, 1ST FLOOR, SHAKER HTS, OH 44122-5203
(216) 286-6260
(216) 286-6341
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
157615
MA
207L00000X
Anesthesiology Physician
Primary
35.094758
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0105511
—
MA
01
—
157615
TUFTS HEALTH PLAN
MA
05
—
1639157241
—
MI
05
—
3015721
—
OH
01
—
J22763
BCBS MA
MA
01
—
P00808469
MEDICARE RAILROAD
OH
Enumeration date
01/04/2006
Last updated
06/02/2010
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