Individual
DR. DIANE MARIE KUSHNAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
5264 LEE RD, MAPLE HEIGHTS, OH 44137-1232
(216) 294-4440
Mailing address
1395 NW 167TH ST STE 120, MIAMI GARDENS, FL 33169-5742
(216) 294-4440
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34006625K
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2074946
—
OH
01
—
384812
ANTHEM PROVIDER NUMBER
OH
01
—
5342673
AETNA PROVIDER NUMBER
OH
01
—
743136652
COMMERCIAL CARRIERS
OH
05
—
743136652028
—
OH
Enumeration date
09/01/2006
Last updated
04/30/2021
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