Individual
VASU SIDAGAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-1000
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
35.084545
OH
207R00000X
Internal Medicine Physician
35-084545
OH
208M00000X
Hospitalist Physician
35-084545
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000221222
UNISON
OH
01
—
000000503543
ANTHEM
OH
05
—
2496053
—
OH
01
—
364011
WELLCARE
OH
01
—
742838
BUCKEYE
OH
01
—
7752646
AETNA
OH
01
—
P00209940
RAILROAD MEDICARE
OH
01
—
P00397868
RAILROAD MEDICARE
OH
Enumeration date
07/14/2006
Last updated
08/29/2012
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