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Individual

MRS. MAXINE PAULRAJ-CHARLES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
26908 DETROIT RD, STE. 200, WESTLAKE, OH 44145-2398
(440) 250-8660
(440) 250-8639
Mailing address
22665 BARD AVE, FAIRVIEW PARK, OH 44126-2908
(440) 777-1867

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
COA.13561-NP
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0075883
OH
Enumeration date
10/10/2012
Last updated
09/06/2016
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