Individual
IGOR A LANTSBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4200 WARRENSVILLE CENTER RD, STE 344, BEACHWOOD, OH 44122-7051
(216) 561-8844
(216) 561-8894
Mailing address
4200 WARRENSVILLE CENTER RD, STE 344, BEACHWOOD, OH 44122-7051
(216) 561-8844
(216) 561-8894
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35042712
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000129201
ANTHEM
OH
05
—
0376454
—
OH
01
—
102353
KAISER
OH
01
—
110064729
RR MEDICARE
OH
01
—
341264282
CHAMPUS/TRICARE
OH
01
—
341264282026
CARESOURCE
OH
01
—
58931
QUALCHOICE
OH
01
—
R42712
SUMMACARE
OH
Enumeration date
09/20/2006
Last updated
09/16/2008
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