Organization
RICHARD A. STATESIR,MD INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD A. STATESIR MD (PHYSICIAN)
(216) 228-9122
Entity
Organization
Contact information
Practice address
14701 DETROIT AVE, SUITE 280, LAKEWOOD, OH 44107-4115
(216) 228-9122
Mailing address
14701 DETROIT AVE, SUITE 280, LAKEWOOD, OH 44107-4115
(216) 228-9122
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
053677
OH
Other
Enumeration date
03/30/2010
Last updated
02/10/2012
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